Medicus, Vol. 33 No. 1 Tromboembolije, 2024.
Review article
Prevention of Stroke in Patients with Atrial Fibrillation
Ana Jordan
Šime Manola
Abstract
A holistic or integrated approach to the treatment of atrial fibrillation is recommended to reduce the risk of stroke. This approach is based on the proven pathway of better care for atrial fibrillation (ABC), which consists of: A) avoiding strokes with anticoagulant therapy; B) making better patient-centered, symptom-focused rate or rhythm control decisions; and C) intervening in cardiovascular risk factors and optimizing comorbidities, including lifestyle modification. Prevention of stroke in patients with atrial fibrillation is one of the main pillars in the treatment of patients with this arrhythmia. The introduction of oral anticoagulants that are not vitamin K antagonists (also called direct oral anticoagulants) has changed our approach to stroke prevention in atrial fibrillation. Compared with rate control, an early rhythm control strategy is also beneficial in reducing stroke in selected patients with recent-onset atrial fibrillation. Management of cardiovascular risk factors while optimizing comorbidities is also crucial. For patients with absolute contraindications for long-term oral anticoagulation, left atrial occlusion or exclusion may be considered.
Keywords
atrial fibrillation; stroke; prevention; anticoagulants; direct oral anticoagulants; left atrial occlusion
Hrčak ID:
321773
URI
Publication date:
24.10.2024.
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