Atrial fibrillation (AF) is an established independent risk factor for stroke. A new medicine called edoxaban has been cleared to prevent blood clots and stroke in patients with AFib. Edoxoban is also a NOAC (non-vitamin K oral anticoagulant). AF burden assessment with a clinical risk score to refine and individualize the assessment of stroke risk in AF-the CHA2DS2VASc-AFBurden score. AF burden can be defined by longest duration; number of AF episodes during a monitoring period, and the proportion of time an individual are in AF during a monitoring period. AF burden is associated with higher risk of stroke. It is unclear whether the risk increases continuously or whether a threshold exists; if a threshold exists, it has not been defined. Higher burden of AF is also associated with higher prevalence and incidence of heart failure and higher risk of mortality, but not necessarily lower quality of life. A structured and comprehensive risk factor management program targeting risk factors, weight loss, and maintenance of a healthy weight appears to be effective in reducing AF burden. Despite this growing understanding of AF burden, research is needed into validation of definitions and measures of AF burden, determination of the threshold of AF burden that results in an increased risk of stroke that warrants anticoagulation, and discovery of the mechanisms underlying the weak temporal correlations of AF and stroke. Moreover, developments in monitoring technologies will likely change the landscape of long-term AF monitoring and could allow better definition of the significance of changes in AF burden over time. Atrial fibrillation (AF) is a serious public health problem because of its increasing incidence and prevalence in the aging population and its association with elevated risks of cardiovascular events and death.

Although one would expect that AF burden should be directly proportional to stroke risk, current guidelines recommend assessing stroke risk on the basis of the individual patient risk profile, not on AF type, pattern, or burden. The approach to risk stratification has been constrained by the fact that the decision to anticoagulate is binary and risks attributable to patient characteristics those included in the CHA2DS2-VASc score, for instance have been thought to overwhelm the risk attributable to AF pattern. On its own, a particular AF pattern is unlikely to spare high-risk patients from anticoagulation or warrant OAC use for low-risk patients. Nonetheless, understanding the relationship between AF pattern and stroke risk might yield some pathophysiological insight into this disease process and motivate further investigation in stroke prevention. Untreated AFib can raise your risk for problems like a heart attack, stroke, and heart failure, which could shorten your life expectancy. But treatments and lifestyle changes can help prevent these problems and manage your risks.

Media Contact:

John Mathews

Journal Manager

Current Trends in Cardiology

Email: cardiologyres@eclinicalsci.com