Incidental atrial fibrillation and its management.

Abstract:

:Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia, yet because AF can often be intermittent or lacking in overt symptoms, its prevalence is underestimated, and it may be diagnosed only incidentally. Because AF is a potent ischemic stroke risk factor and stroke rates are similar for paroxysmal, persistent, and permanent AF, all AF types require prompt management. This involves identifying and treating underlying causative factors, then implementing a "rate-control" or "rhythm-control" strategy. Regardless of approach, concomitant antithrombotic therapy for stroke risk reduction is recommended. Antithrombotic agent choice (acetylsalicylic acid or warfarin) depends on level of stroke risk; this review covers both the CHADS2 and CHA2DS2-VASc risk stratification schemes. Warfarin provides effective ischemic stroke prophylaxis but has numerous drawbacks, including a narrow therapeutic range, unpredictable pharmacokinetics, slow on-/offset of action, and multiple food and drug interactions. New oral anticoagulants that lack many of these drawbacks are in development. Here we review these drugs for stroke prevention in AF.

journal_name

Postgrad Med

journal_title

Postgraduate medicine

authors

Saliba W

doi

10.3810/pgm.2011.03.2260

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

27-35

issue

2

eissn

0032-5481

issn

1941-9260

journal_volume

123

pub_type

杂志文章,评审
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