Stroke Prevention in Non-Valvular Atrial Fibrillation
Date of Award
Spring 2022
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Kevin Basile, MD, PT
Second Advisor
Samantha Creamer, PA-C, MPAS
Abstract
Atrial Fibrillation (AF) is the most commonly-treated cardiac arrhythmia in the world. In AF, unsynchronized action potentials in the pulmonary veins and left atrium lead to uneven contractions of the atrial muscle cells, resulting in an irregularly irregular heart rhythm and inadequate blood flow out of the heart. The major complication that stems from untreated AF is a thromboembolic stroke event. While Warfarin has been the long-standing treatment option in preventing stroke, there are several other available options that patients may consider, including Direct Oral Anticoagulants (DOACs), such as Apixaban (aka Eliquis) and Rivaroxiban (aka Xarelto). An additional and more recent option is occlusion of the left atrial appendage (LAAO), a pocket structure and the most common site for thrombus formation. The only FDA approved device in the US currently for LAAO is the WATCHMAN device. This review defines atrial fibrillation, explains different risk assessment tools in stroke prevention, and outlines the available prophylaxis options while weighing risks and benefits.
Recommended Citation
Wilmoth, Tommy, "Stroke Prevention in Non-Valvular Atrial Fibrillation" (2022). Capstone Showcase. 47.
https://scholarworks.arcadia.edu/showcase/2022/pa/47
Stroke Prevention in Non-Valvular Atrial Fibrillation
Atrial Fibrillation (AF) is the most commonly-treated cardiac arrhythmia in the world. In AF, unsynchronized action potentials in the pulmonary veins and left atrium lead to uneven contractions of the atrial muscle cells, resulting in an irregularly irregular heart rhythm and inadequate blood flow out of the heart. The major complication that stems from untreated AF is a thromboembolic stroke event. While Warfarin has been the long-standing treatment option in preventing stroke, there are several other available options that patients may consider, including Direct Oral Anticoagulants (DOACs), such as Apixaban (aka Eliquis) and Rivaroxiban (aka Xarelto). An additional and more recent option is occlusion of the left atrial appendage (LAAO), a pocket structure and the most common site for thrombus formation. The only FDA approved device in the US currently for LAAO is the WATCHMAN device. This review defines atrial fibrillation, explains different risk assessment tools in stroke prevention, and outlines the available prophylaxis options while weighing risks and benefits.
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