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Atrial Fibrillation: Guidelines Put Stroke in Focus

Posted on: Friday, 4 August 2006, 12:00 CDT

Stroke, a disabling complication of atrial fibrillation, has received more attention in the revised guidelines for the management of atrial fibrillation. This increased focus on stroke should play a leading role in helping reduce the incidence of ischemic stroke among atrial fibrillation patients, as well as bringing the ultimate goal of preventing stroke in these patients a step closer.

Atrial fibrillation (AF) is the most common arrhythmia characterized by uncoordinated atrial activation where electrical signals in the atria are fired in a fast and uncontrolled manner, causing an irregular fast heartbeat.

The guidelines for the treatment of AF have recently been jointly updated by American College of Cardiology, American Heart Association and European Society of Cardiology. The previous set of guidelines came out in 2001, and since then a large amount of research has been done, both regarding the different strategies in AF treatment and prevention of ischemic stroke.

It seems the results of this research are now finding their way into the official guidelines. This is significant as several important revelations have been made by scientists working in this field in recent years. For example, in July, a study concluded that there are 5.6 million people with AF in the US - a big difference compared to the 2.2 million figure that all of the major cardiology organizations had previously accepted. This finding has strengthened the belief that the developed world is experiencing an AF epidemic.

The previous guidelines recommended using several patient characteristics - namely age, gender, heart disease risk and concurrent conditions - to decide which antithrombotic therapy to administer to AF patients. The revised joint guidelines, however, recommend that the risk for stroke should be the main decision-influencing factor. This should prove good news for AF patients as stroke is one of the most dangerous complications associated with AF, and up to 20% of strokes are estimated to occur in people with AF.

In addition, the revised guidelines state that patients with no stroke risk factors should be given daily aspirin therapy to guard against blood clots.

Incorporating the guidelines from primary stroke prevention into the AF guidelines, and thus making the recommendations clearer for physicians, is likely to have a significant impact upon cutting the incidence of ischemic stroke among AF patients. Overall, the new guidelines bring the medical community a step closer to the goal of preventing stroke in AF patients.

Source: Datamonitor

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