Atrial fibrillation (AF) significantly elevates stroke risk, making prevention essential.
The CHA₂DS₂-VASc score helps evaluate stroke risk based on factors: Heart failure, Hypertension, Age particularly ≥75 years Diabetes History of stroke or thromboembolism, vascular disease, Sex
Anticoagulation therapy is central to stroke prevention in AF patients.
Direct Oral Anticoagulants (DOACs) are preferred for non-valvular AF.
Options: Apixaban, Rivaroxaban, Dabigatran, Edoxaban
DOACs Advantages-Fixed dosing, fewer interactions, no regular monitoring Vitamin K Antagonists Necessary for patients with mechanical heart valves or moderate-severe mitral stenosis. Requires regular INR monitoring, with a target range of 2.0-3.0.
Left Atrial Appendage Management: For those intolerant to anticoagulation: Devices: WATCHMAN, AMPLATZER Surgical closure during heart surgery
Rate Control focuses on managing heart rate without restoring sinus rhythm.
Rhythm Control aims to restore normal sinus rhythm and could reduce stroke risk. Includes cardioversion, antiarrhythmics, and ablation.
Additional Prevention Strategies
Blood Pressure Management Lipid Management Lifestyle Modifications-Smoking cessation, moderate alcohol intake or abstinence, weight management, regular exercise, and sleep apnea treatment.