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- Publisher Website: 10.1093/europace/euad226
- Scopus: eid_2-s2.0-85168734314
- WOS: WOS:001054221500001
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Article: Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal
Title | Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal |
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Authors | |
Keywords | Ablation Anticoagulation Atrial fibrillation Bleeding risk Pacemaker Rhythm control Stroke prevention |
Issue Date | 2-Aug-2023 |
Publisher | Oxford University Press |
Citation | EP Europace, 2023, v. 25, n. 9 How to Cite? |
Abstract | Stroke prevention in patients with atrial fibrillation (AF) is one pillar of the management of this common arrhythmia. Substantial advances in the epidemiology and associated pathophysiology underlying AF-related stroke and thrombo-embolism are evident. Furthermore, the introduction of the non-vitamin K antagonist oral anticoagulants (also called direct oral anticoagulants) has clearly changed our approach to stroke prevention in AF, such that the default should be to offer oral anticoagulation for stroke prevention, unless the patient is at low risk. A strategy of early rhythm control is also beneficial in reducing strokes in selected patients with recent onset AF, when compared to rate control. Cardiovascular risk factor management, with optimization of comorbidities and attention to lifestyle factors, and the patient's psychological morbidity are also essential. Finally, in selected patients with absolute contraindications to long-term oral anticoagulation, left atrial appendage occlusion or exclusion may be considered. The aim of this state-of-the-art review article is to provide an overview of the current status of AF-related stroke and prevention strategies. A holistic or integrated care approach to AF management is recommended to minimize the risk of stroke in patients with AF, based on the evidence-based Atrial fibrillation Better Care (ABC) pathway, as follows: A: Avoid stroke with Anticoagulation; B: Better patient-centred, symptom-directed decisions on rate or rhythm control; C: Cardiovascular risk factor and comorbidity optimization, including lifestyle changes. |
Persistent Identifier | http://hdl.handle.net/10722/338245 |
ISSN | 2023 Impact Factor: 7.9 2023 SCImago Journal Rankings: 2.895 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lip, Gregory Y H | - |
dc.contributor.author | Proietti, Marco | - |
dc.contributor.author | Potpara, Tatjana | - |
dc.contributor.author | Mansour, Moussa | - |
dc.contributor.author | Savelieva, Irina | - |
dc.contributor.author | Tse, Hung Fat | - |
dc.contributor.author | Goette, Andreas | - |
dc.contributor.author | Camm, A John | - |
dc.contributor.author | Blomstrom-Lundqvist, Carina | - |
dc.contributor.author | Gupta, Dhiraj | - |
dc.contributor.author | Boriani, Giuseppe | - |
dc.date.accessioned | 2024-03-11T10:27:21Z | - |
dc.date.available | 2024-03-11T10:27:21Z | - |
dc.date.issued | 2023-08-02 | - |
dc.identifier.citation | EP Europace, 2023, v. 25, n. 9 | - |
dc.identifier.issn | 1099-5129 | - |
dc.identifier.uri | http://hdl.handle.net/10722/338245 | - |
dc.description.abstract | <p>Stroke prevention in patients with atrial fibrillation (AF) is one pillar of the management of this common arrhythmia. Substantial advances in the epidemiology and associated pathophysiology underlying AF-related stroke and thrombo-embolism are evident. Furthermore, the introduction of the non-vitamin K antagonist oral anticoagulants (also called direct oral anticoagulants) has clearly changed our approach to stroke prevention in AF, such that the default should be to offer oral anticoagulation for stroke prevention, unless the patient is at low risk. A strategy of early rhythm control is also beneficial in reducing strokes in selected patients with recent onset AF, when compared to rate control. Cardiovascular risk factor management, with optimization of comorbidities and attention to lifestyle factors, and the patient's psychological morbidity are also essential. Finally, in selected patients with absolute contraindications to long-term oral anticoagulation, left atrial appendage occlusion or exclusion may be considered. The aim of this state-of-the-art review article is to provide an overview of the current status of AF-related stroke and prevention strategies. A holistic or integrated care approach to AF management is recommended to minimize the risk of stroke in patients with AF, based on the evidence-based Atrial fibrillation Better Care (ABC) pathway, as follows: A: Avoid stroke with Anticoagulation; B: Better patient-centred, symptom-directed decisions on rate or rhythm control; C: Cardiovascular risk factor and comorbidity optimization, including lifestyle changes. </p> | - |
dc.language | eng | - |
dc.publisher | Oxford University Press | - |
dc.relation.ispartof | EP Europace | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Ablation | - |
dc.subject | Anticoagulation | - |
dc.subject | Atrial fibrillation | - |
dc.subject | Bleeding risk | - |
dc.subject | Pacemaker | - |
dc.subject | Rhythm control | - |
dc.subject | Stroke prevention | - |
dc.title | Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal | - |
dc.type | Article | - |
dc.identifier.doi | 10.1093/europace/euad226 | - |
dc.identifier.scopus | eid_2-s2.0-85168734314 | - |
dc.identifier.volume | 25 | - |
dc.identifier.issue | 9 | - |
dc.identifier.eissn | 1532-2092 | - |
dc.identifier.isi | WOS:001054221500001 | - |
dc.identifier.issnl | 1099-5129 | - |