RT Journal Article
SR Electronic
T1 Atrial fibrillation and stroke: a practical guide
JF Practical Neurology
JO Pract Neurol
FD BMJ Publishing Group Ltd
SP 208
OP 224
DO 10.1136/practneurol-2018-002089
VO 19
IS 3
A1 Jonathan Gordon Best
A1 Robert Bell
A1 Mohammed Haque
A1 Arvind Chandratheva
A1 David John Werring
YR 2019
UL http://pn.bmj.com/content/19/3/208.abstract
AB Neurologists and stroke physicians will be familiar with atrial fibrillation as a major cause of ischaemic stroke, and the role of anticoagulation in preventing cardioembolic stroke. However, making decisions about anticoagulation for individual patients remains a difficult area of clinical practice, balancing the serious risk of ischaemic stroke against that of major bleeding, particularly intracranial haemorrhage. Atrial fibrillation management requires interdisciplinary collaboration with colleagues in cardiology and haematology. Recent advances, especially the now-widespread availability of direct oral anticoagulants, have brought opportunities to improve stroke care while posing new challenges. This article gives an overview of the contemporary diagnosis and management of atrial fibrillation, and the associated evidence base. Where there is uncertainty, we describe our own approach to these areas, while highlighting ongoing research that will likely guide future practice.