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Background: Stroke Prevention in Patients with Atrial Fibrillation

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Clinical Cases in LAA Occlusion

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Abstract

The need for effective stroke prevention in patients with atrial fibrillation increases with age. Several studies found platelet inhibition to be ineffective. Thus, for many years oral anticoagulation had been the only pharmacological option. Given the associated bleeding risk especially in the elderly warfarin is underused. Intracerebral bleeding is particularly problematic as it usually leads to dramatic clinical consequences. The introduction of non-vitamin K antagonists (NOAC) - specific oral anticoagulants directed at factor X or II - has reduced the risk of intracranial bleeding. Yet the rate of total bleeding events, particularly gastrointestinal, bladder and skin bleeding, largely remained unchanged. In addition, compliance to these drugs is an issue. Recent guidelines have incorporated interventional stroke protection, namely LAA occluder therapy, to be part of the routine treatment algorithm. This chapter summarizes the current evidence regarding the different options for stroke prevention in patients with atrial fibrillation.

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Acknowledgment

The authors would like to thank Mrs. Elisa Vireca, MS, Boston Scientific, Diegem, Belgium for critical reading and helpful comments.

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  1. Standort Wandsbek, Cardiologicum Hamburg, Hamburg, Germany

    Martin W. Bergmann

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  1. Martin W. Bergmann
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Correspondence to Martin W. Bergmann .

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Bergmann, M.W. (2017). Background: Stroke Prevention in Patients with Atrial Fibrillation. In: Clinical Cases in LAA Occlusion. Springer, Cham. https://doi.org/10.1007/978-3-319-51431-4_1

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  • DOI: https://doi.org/10.1007/978-3-319-51431-4_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51429-1

  • Online ISBN: 978-3-319-51431-4

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