Trends in the management of atrial fibrillation: A neurologist’s perspective
Atrial Fibrillation Thursday, October 25th, 2012Journal of Cardiovascular Disease Research: October 19, 2012
Atrial fibrillation (AF) is recognized as the most common cardiac arrhythmia, accounting for a lifetime risk of about 25%. [1],[2],[3] It presents a 5-6 fold increased stroke risk and accounts for at least one in every seven ischemic strokes. The common conception is that highest risk of embolic stroke is in those who develop thrombus formation in the left atrial appendage (LAA). The burden of disease rests on the elderly, as half of all patients with AF are over the age of 75. [4] Given the dramatic increase in the aging population in the United States, it has been estimated that disease prevalence will be more than double by 2050, which might be equivalent to 5.6-12.1 million adults. [4],[5] This increase in AF will contribute an additional 170,000 annual strokes, the equivalent of nearly 25% of the current stroke incidence, including significant burden on the economy [Table 1]. The risk of AF-related stroke mortality can be up to 24% in those aged 80-89 years. In the setting of AF, oral anticoagulation (OA) has proven to reduce the risk of ischemic stroke by 60% when compared to placebo and 52% fewer strokes when compared to aspirin. However, first generations OA (such as warfarin) are not well accepted by patients, families, and even clinicians often because the risk of hemorrhage is often anecdotally exaggerated. Read more
