Are Ischemic Strokes the Same? The Special Case Argument of Atrial Fibrillation

Card Electrophysiol Clin. 2023 Jun;15(2):111-117. doi: 10.1016/j.ccep.2023.01.003.

Abstract

A comprehensive evaluation is necessary to identify the etiologic factors in order to select optimal stroke-prevention measures. Atrial fibrillation is one of the most important stroke causes. Although anticoagulant therapy is the treatment of choice for patients with nonvalvular atrial fibrillation, it should not be considered uniformly to treat all patients given the high mortality associated with anticoagulant-related hemorrhages. The authors propose a risk-stratified individualized approach for stroke prevention in patients with nonvalvular atrial fibrillation by considering nonpharmacologic approaches for patients at high hemorrhage risk or otherwise unsuitable for lifelong anticoagulation.

Keywords: Anticoagulation; Atrial fibrillation; Intracerebral hemorrhage; Ischemic stroke; Left atrial appendage closure; Stroke prevention.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anticoagulants / therapeutic use
  • Atrial Appendage*
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / therapy
  • Humans
  • Ischemic Stroke* / chemically induced
  • Ischemic Stroke* / complications
  • Ischemic Stroke* / drug therapy
  • Stroke* / etiology
  • Stroke* / prevention & control
  • Treatment Outcome

Substances

  • Anticoagulants