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[Anticoagulation in atrial fibrillation: not yet settled]
R Montagna1, R Asenjo, R Madariaga
1Centro Nacional de Arritmias, Hospital Clínico Universidad de Chile, Santiago, Chile.
Insights
Atrial fibrillation, a common heart rhythm disorder, poses risks of blood clots and stroke. This review covers anticoagulation strategies for non-rheumatic atrial fibrillation, aiding risk assessment and treatment choices.
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Context:
- Atrial fibrillation is the most prevalent adult arrhythmia.
- Complications, particularly thrombi formation and embolization, are significant concerns.
- Effective anticoagulation is crucial for preventing embolic events in atrial fibrillation.
Purpose:
- To review current anticoagulation practices for non-rheumatic atrial fibrillation.
- To provide tools for assessing embolic risk.
- To guide anticoagulant selection based on atrial fibrillation presentation.
Summary:
- This review synthesizes the current understanding of anticoagulation in atrial fibrillation, excluding cases related to rheumatic valvulopathy.
- It details risk factors for embolic complications and evaluates the efficacy of anticoagulant therapies.
- The work offers practical guidance for risk stratification and personalized anticoagulant selection.
Impact:
- Enhances clinical decision-making for managing atrial fibrillation.
- Aims to reduce the incidence of stroke and systemic embolism in affected patients.
- Provides a valuable resource for healthcare professionals treating atrial fibrillation.
Abstract:
A great deal of interest has received atrial fibrillation, the most common arrhythmia in adults, due to its complications and difficult treatment its most dreaded complication is atrial thrombi formation with the subsequent risk of embolization. There are several reports defining risk factors for embolic complications and the usefulness of anticoagulants for their prevention. We review the state of the art of anticoagulation in atrial fibrillation not associated to rheumatic valvulopathy. We also give tools to assess embolic risk and to determine the anticoagulant choice for the different presentation forms of atrial fibrillation.