NDLI: Stroke in atrial fibrillation

Content Provider	PubMed Central
Author	Shahnaz, Jamil-copley Kanagaratnam, Prapa
Copyright Year	2010
Abstract	Atrial fibrillation (AF), a chaotic and irregular contraction of the atria, remains the most common cardiac arrhythmia affecting up to 1.5 per cent of the world population. It has significant economic and personal implications primarily owing to the associated fivefold increase in risk of thromboembolic stroke. The mainstay of risk reduction therapy remains warfarin, use of which can be limited owing to a multitude of issues ranging from drug and food interactions to under-treatment reflected in sub-therapeutic blood levels despite adequate compliance. Pursuit of novel drug alternatives have led to the licence of a new contender (Dabigatran) with a more attractive pharmacotherapeutic profile, some 50 years after warfarin was introduced for human use. A recent non-pharmacological alternative is the Watchman device which has received licence for use. Tested in the PROTECT-AF study, the Watchman device was found to be non-inferior to warfarin in the occurrence of stroke, cardiovascular or unexplained death, or systemic emboli for up to 3 years with less intracranial haemorrhages. The events in the watchman group occurred early and were related to the procedure. These peri-procedural complications are likely to diminish with improved operator experience and ongoing development of the technology. For now, patients with AF who would benefit tremendously from but cannot be treated with warfarin owing to contraindication to, or intolerance of, anticoagulation are considered for device implantation. Despite promising new pharmacotherapeutic advances in the prevention of strokes related to AF, it has taken 50 years for alternative non-pharmacological approaches to become available for clinical use.
Related Links	http://dx.doi.org/10.1098/rsif.2010.0344.focus
Starting Page	765
File Format	PDF
ISSN	17425689
e-ISSN	17425662
Journal	Journal of the Royal Society Interface
Issue Number	Suppl 6
Volume Number	7
Language	English
Publisher	The Royal Society
Publisher Date	2010-12-06
Access Restriction	Open
Rights Holder	The Royal Society
Subject Keyword	Biotechnology Biophysics Biochemistry Bioengineering Biomaterials Biomedical Engineering Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Biochemistry Biomaterials Biophysics Bioengineering Biomedical Engineering Biotechnology

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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