What Is the Treatment of Atrial Fibrillation? Stroke Prevention and Risk Factor Management
Clinical Scenario
Atrial fibrillation carries an elevated risk of ischaemic stroke and systemic thromboembolism, and is closely linked to modifiable cardiovascular risk factors and comorbidities that drive its burden and progression. Effective management addresses both the thromboembolic risk and the underlying conditions contributing to AF.
Treatment Approach
The structured protocol combines comprehensive identification and management of risk factors and comorbidities with oral anticoagulation for stroke prevention — the full clinical algorithm, selection criteria, and complete set of therapeutic options are in the complete protocol.
Key Clinical Targets
- Treated systolic blood pressure 120–129 mmHg; diastolic blood pressure 70–79 mmHg
- Body weight reduction of 10% or more in overweight and obese individuals
- INR 2.0–3.0 for patients receiving a vitamin K antagonist
References
DOI: 10.1093/eurheartj/ehae176
- Identification and management of risk factors and comorbidities is recommended as an integral part of AF care.
- Oral anticoagulation is recommended in patients with clinical AF at elevated thromboembolic risk to prevent ischaemic stroke and thromboembolism.
- The target for treated systolic blood pressure (BP) in most adults is 120–129 mmHg.
- On-treatment diastolic BP should ideally be 70–79 mmHg.
- Weight loss is recommended as part of comprehensive risk factor management in overweight and obese individuals with AF to reduce symptoms and AF burden, with a target of 10% or more reduction in body weight.
- A target INR of 2.0–3.0 is recommended for patients with AF prescribed a VKA for stroke prevention to ensure safety and effectiveness.
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