Stroke prevention in atrial fibrillation: An update

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia and, if left untreated, is a significant risk factor for stroke and heart failure. In order to reduce AF-related stroke, it is essential that the relevant population be identified, risk stratified and offered appropriate interventions to reduce their risk. The risk of stroke is not influenced by the pattern of AF shown in the patient; paroxysmal, persistent or permanent AF. All result in an increased stroke risk and all patients should have their individual level of risk assessed accordingly. Patients at high risk of stroke should be anticoagulated without delay. There are currently suboptimal levels of anticoagulation throughout the UK which, if addressed, could potentially save a significant number of lives and reduce strokes within the population. The introduction of novel oral anticoagulants that can be offered as an alternative to warfarin should help clinicians to find acceptable treatment options for patients who are at risk.