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Updated: Sep 16, 2025
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
33.5K
Managing Stroke Risk in Moyamoya Disease With Paroxysmal Atrial Fibrillation: A Case Report
Ahmed Kazi1, Aniq Saleem2, Abeera Akram3
1Internal Medicine, Saint Francis Hospital, Hartford, USA.
Cureus
|July 11, 2025
Summary
Managing atrial fibrillation (AF) in Moyamoya disease patients is complex. This case shows individualized anticoagulation with apixaban, balancing stroke and hemorrhage risks, is crucial for these patients.
Area of Science:
- Neurology
- Cardiology
Background:
- Moyamoya disease involves progressive cerebrovascular narrowing, increasing stroke risk.
- Atrial fibrillation (AF) in Moyamoya disease patients presents dual thromboembolic and hemorrhage risks.
Observation:
- A 40-year-old female with Moyamoya disease, prior strokes, and hypertension presented with paroxysmal AF detected by an implantable loop recorder.
- Heart rate was controlled with beta-blockers, but anticoagulation was recommended due to a high CHA₂DS₂-VASc score.
Findings:
- Anticoagulation with apixaban was initiated after neurologist consultation, weighing risks of hemorrhage against thromboembolism.
- Catheter ablation for AF was considered but not yet performed.
Implications:
- This case underscores the need for individualized treatment strategies in patients with concurrent Moyamoya disease and AF.
- Careful consideration of anticoagulation versus antiplatelet therapy is essential for optimizing stroke prevention while minimizing bleeding risk.
Keywords:
anticoagulationantiplatelet therapyatrial fibrillationcatheter ablationcerebrovascular diseasecollateral vesselscoronary artery diseasehypertensionmoyamoya diseasestrokeMore Related Videos
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