New Avenues for Optimal Treatment of Atrial Fibrillation and Stroke Prevention

Gian Marco De Marchis, Luciano A. Sposato, Michael Kühne, Tolga D. Dittrich, Leo H. Bonati, Urs Fischer, Seemant Chaturvedi

Research output: Contribution to journalReview articlepeer-review

Abstract

One in 3 individuals free of atrial fibrillation (AF) at index age 55 years is estimated to develop AF later in life. AF increases not only the risk of ischemic stroke but also of dementia, even in stroke-free patients. In this review, we address recent advances in the heart-brain interaction with focus on AF. Issues discussed are (1) the timing of direct oral anticoagulants start following an ischemic stroke; (2) the comparison of direct oral anticoagulants versus vitamin K antagonists in early secondary stroke prevention; (3) harms of bridging with heparin before direct oral anticoagulants; (4) importance of appropriate direct oral anticoagulants dosing; (5) screening for AF in high-risk populations, including the role of wearables; (6) left atrial appendage occlusion as an alternative to oral anticoagulation; (7) the role of early rhythm-control therapy; (8) effect of lifestyle interventions on AF; (9) AF as a risk factor for dementia. An interdisciplinary approach seems appropriate to address the complex challenges posed by AF.

Original languageEnglish (US)
Pages (from-to)1490-1499
Number of pages10
JournalStroke
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • anticoagulant
  • atrial appendage
  • atrial fibrillation
  • dementia
  • hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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