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WATCHMAN device as an alternative method to stroke prevention in patients with non-valvular atrial fibrillation

REVIEW, November 2014, VOL III ISSUE I, ISSN 2042-4884
10.5083/ejcm.20424884.126 , Cite or Link Using DOI
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Richard Ang, Richard J Schilling

INTRODUCTION

The current estimated prevalence of atrial fibrillation (AF) in the developed world is approximately 1.5 – 2% of the general population, with a projected doubling of this figure by the year 2030 (1, 2). Thromboembolic events due to embolisation of atrial thrombi is a major concern in patients with AF. Ischaemic stroke is the most common and debilitating clinical manifestation of embolisation associated with AF with a five-fold increase in risk in the elderly (3) and resulting in clinically more severe strokes (4).

Oral anticoagulation, most commonly with vitamin K antagonist such as warfarin, is the mainstay of treatment to reduce the risk of stroke associated with AF. In the clinical setting, risk stratification taking into account patient factors is used to guide the use of anticoagulation therapy (1, 5).

However, use of oral anticoagulation is associated with bleeding risks and its use may be precluded in patients with high risk of bleeding, including patients with previous cerebral bleeds and intolerance to oral anticoagulation drugs.