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Study advocates continued use of anticoagulants in patients with resolved atrial fibrillation

Treatment with anticoagulants reduces risk of stroke by two thirds

Treatment with anticoagulants reduces risk of stroke by two thirds

Anticoagulants such as warfarin reduce stroke risk by two thirds. Picture: iStock

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with a fivefold increase in the risk of stroke and transient ischaemic attack (TIA). Treatment with anticoagulants reduces this risk by about two thirds.

AF is described as resolved once normal cardiac rhythm is restored, but subsequent recurrence is possible. Long-term success rates of ablation, where some cardiac tissue is destroyed to block abnormal electrical pathways, might be as low as 20%. Such patients might remain at increased risk of stroke and could continue to benefit from anticoagulant prophylaxis.

In England, patients with resolved AF are excluded from the scheme that incentivises management of patients with AF in primary care. Guidance states that these patients should be removed from the register.

This study examined data from more than 11,000 people with resolved AF. Researchers aimed to determine rates of stroke or TIA and all-cause mortality in patients with a diagnosis of resolved AF compared with those with unresolved AF or without AF.

Results and implications for practice

Findings showed that patients with resolved AF were at similar risk of stroke or TIA to patients with ongoing AF. They are, however, one fifth as likely to receive anticoagulants. The authors recommend that guidelines are updated to advocate continued use of anticoagulant treatments in patients with resolved AF.


About the author

Ruth Sander is an independent consultant in care of older people

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