Anticoagulation in Atrial Fibrillation – Current Concepts

Thrombotic material in atrial fibrillation(AF) usually develops in the left atrial appendage as a result of decreased flow and stasis, possible endothelial dysfunction and a hypercoagulable state as indicated by increased fibrinogen, D-dimer, thromboglobulin and platelet factor 4 levels.1 In the Framingham Heart Study, the percentage of strokes attributable to AF increases steeply from 1.5 % in patients aged 50–59 years to 23.5 % in those aged 80–89 years.2

Recent Atrial Fibrillation Guidelines - Looking at Both Sides of the Atlantic

Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice and may be associated with symptoms, haemodynamic impairment and frightening embolic complications. In 1998 recommendations on the management of AF were reported by the Working Group of Arrhythmias of the European Society of Cardiology (ESC). 1 The American College of Cardiology (ACC), the American Heart Association (AHA) and the ESC published joint AF guidelines in 2001.