Tag Archives: CHA2DS2-VASc

Drug therapies include anticoagulants to reduce the risk of stroke and anti-arrhythmics to restore/maintain the normal heart rhythm or slow the heart rate in patients who remain in AF. Non-pharmacological management options include electrical cardioversion, which may be used to ‘shock’ the heart back to its normal rhythm. The high risk of stroke associated with electrical cardioversion can be reduced by oral anticoagulation. Although effective in reducing the risk of thromboembolism, the limitations of warfarin present considerable challenges for its use in clinical practice. The challenges of maintaining warfarin within an appropriate th

Understanding the mechanisms of AF lies at the heart of its treatment. AF occurs when structural and/or electrophysiological abnormalities alter atrial tissue to promote abnormal impulse formation and/or propagation (figure 1).3 Multiple clinical risk factors, electrocardiographic/echocardiographic features and biochemical markers are associated with an increased risk of AF (table 1), and, AF can be described in terms of the duration of episodes using a simplified scheme (table 2).3 Figure 1. Mechanisms of atrial fibrillation Table 1. Risk factors3 The aim of treatment is to prevent stroke and alleviate symptoms.4 Drug therapies include antic

Introduction Atrial fibrillation (AF) is the most common cardiac dysrrhythmia, whose sequelae include stroke, heart failure and poor quality of life.1 In parallel with an ageing population, the prevalence of AF is increasing, with persistent or permanent forms affecting 10–15% of the population over the age of 75 years.2-6 The effective management of AF has been a source of recurring debate, leading to the publication of combined American College of Cardiology/American Heart Association/European Society of Cardiology (ACC/AHA/ESC), and National Institute for Health and Clinical Excellence (NICE) guidelines in 2006.7,8 In addition to evidenc

Stroke risk assessment in AF New insights on stroke risk assessment were provided by Dr Ami Banerjee (University of Birmingham), in a session supported by the Atrial Fibrillation Association. Table 1. CHADS2 score The CHADS2 risk stratification scoring system (table 1) is currently the indicator for the Quality and Outcomes (QoF) framework used to determine whether an atrial fibrillation (AF) patient warrants anticoagulation. It may underestimate risk and those with a score of zero may actually be at substantial stroke risk. He also pointed out that the system has inherent disadvantages. It does not include many of the risk factors for stroke