Advances in the management of atrial fibrillation with a special focus on non-pharmacological approaches to prevent thromboembolism: a review of current recommendations

J Investig Med. 2020 Dec;68(8):1317-1333. doi: 10.1136/jim-2020-001500. Epub 2020 Nov 17.

Abstract

Atrial fibrillation (AFIB) is the most common heart rhythm abnormality and is associated with significant morbidity and mortality. While the treatment of AFIB involves strategies of rate with or without rhythm control, it is also essential to strategize appropriate therapies to prevent thromboembolic complications arising from AFIB. Previously, anticoagulation was the main treatment option which exposed patients to higher than usual risk of bleeding. However, with the advent of new technology, novel therapeutic options aimed at surgical or percutaneous exclusion or occlusion of the left atrial appendage in preventing thromboembolic complications from AFIB have evolved. This review evaluates recent advances and therapeutic options in treating AFIB with a special focus on both surgical and percutaneous interventions which can reduce and/or eliminate thromboembolic complications of AFIB.

Keywords: anticoagulants; atrial appendage; atrial fibrillation; cardiovascular diseases; stroke.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation / economics
  • Atrial Fibrillation / therapy*
  • Catheter Ablation
  • Cost-Benefit Analysis
  • Health Planning Guidelines*
  • Humans
  • Randomized Controlled Trials as Topic
  • Thromboembolism / economics
  • Thromboembolism / etiology*
  • Thromboembolism / prevention & control*