Thursday, March 23, 2017

Type of atrial fibrillation and stroke risk

From a recent paper:

Background—Whether the pattern of atrial fibrillation (AF) modifies the risk/benefit of anticoagulation is controversial…

Conclusions—In ENGAGE AF-TIMI 48 trial, patients with paroxysmal AF suffered fewer thromboembolic events and deaths compared with those with persistent and permanent AF.

1 comment:

james gaulte said...

Yes, other articles as well demonstrate lower stroke risk in PAF versus persistent or permanent AF. But I think those studies have not shown that the risk is sufficiently lower to withhold OAC if the stroke risk score reaches generally accepted levels above which the party line is to anticoagulant.
Much less clear is the situation regarding the subclinical atrial fib that occurs in somewhere between 40 and 60% of patients with pacemakers.While generally there is increase stroke risk in these SCAF cases the quest to find a "af burden" threshold above which OAC is needed so far has not been successful.