Open AccessOptimum Risk Assessment for Stroke in Atrial Fibrillation: Should We Hold the Status Quo or Consider Magnitude Synergism and Left Atrial Appendage Anatomy?
Author(s) -
James A. Reiffel
Publication year - 2017
Publication title -
arrhythmia and electrophysiology review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.008
H-Index - 18
eISSN - 2050-3377
pISSN - 2050-3369
DOI - 10.15420/aer.2017.33.1
Subject(s) - atrial fibrillation , medicine , context (archaeology) , stroke (engine) , cardiology , stroke risk , appendage , embolism , status quo , atrial appendage , ischemic stroke , anatomy , mechanical engineering , paleontology , market economy , ischemia , sinus rhythm , economics , engineering , biology
Thromboembolic stroke and systemic embolism are generally agreed to be the major morbidity/mortality concerns for patients with AF. However, the risk of thromboembolism is not the same for all AF patients. Both AF and comorbidities must interact synergistically to create the risk for thromboembolism. But, is the synergism dichotomous – AF present or absent, comorbid disorder present or absent – or does synergism have magnitude, depending on the number and severity of the associated disorders and the amount of time one is in AF? This review discusses the current risk-score contributors and options for assessing risk of thromboembolism in AF patients, and what their combined roles might be. Also covered is the consideration of left atrial appendage anatomy in this context.