Invasive treatment of patients with atrial fibrillation and high risk of bleeding

    Authors

    Keywords

    atrial fibrillation, pulmonary vein isolation, left atrial appendage occluder

    DOI

    https://doi.org/10.15836/ccar2022.309

    Full Text

    Atrial fibrillation (AF) is the most common long-term cardiac arrhythmia found in a wide population of people and is closely associated with an increased risk of death, cerebrovascular insult and other thromboembolic incidents ( 1 ). Based on the symptoms and duration of AF, physicians choose a treatment strategy, which can be a frequency control strategy or a rhythm control strategy. In the patient whose case we have described, a rhythm control strategy was chosen, which was carried out with antiarrhythmic therapy and isolation of the pulmonary veins ( 2 ). Likewise, in patients with AF, it is necessary to choose the correct anticoagulation therapy. The guidelines emphasize the assessment of risk factors for a thromboembolic event using the Congestive Heart Failure, Hypertension, Age ≥75 [Doubled], Diabetes Mellitus, Prior Stroke or Transient Ischemic Attack [Doubled], Vascular Disease, Age 65–74, Female or CHA2DS2-VASc score. Also, the risk of bleeding should be considered, and for this purpose the Hypertension, Abnormal liver/renal function, Stroke history, Bleeding history or predisposition, Labile INR, Elderly, Drug/alcohol usage or HAS-BLED scoring system is used. In the patient whose case we have described, in addition to cryoablation of the pulmonary veins, an occluder of the left atrial appendage (LAAO) was placed in the same act.

    Cardiologia Croatica
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    Invasive treatment of patients with atrial fibrillation and high risk of bleeding

    Extended Abstract
    Issue9-10
    Published
    Pages309
    PDF via DOIhttps://doi.org/10.15836/ccar2022.309
    atrial fibrillation
    pulmonary vein isolation
    left atrial appendage occluder

    Authors

    Matija Mlinar*ORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Zvonimir KatićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia

    Full Text

    Atrial fibrillation (AF) is the most common long-term cardiac arrhythmia found in a wide population of people and is closely associated with an increased risk of death, cerebrovascular insult and other thromboembolic incidents ( 1 ). Based on the symptoms and duration of AF, physicians choose a treatment strategy, which can be a frequency control strategy or a rhythm control strategy. In the patient whose case we have described, a rhythm control strategy was chosen, which was carried out with antiarrhythmic therapy and isolation of the pulmonary veins ( 2 ). Likewise, in patients with AF, it is necessary to choose the correct anticoagulation therapy. The guidelines emphasize the assessment of risk factors for a thromboembolic event using the Congestive Heart Failure, Hypertension, Age ≥75 [Doubled], Diabetes Mellitus, Prior Stroke or Transient Ischemic Attack [Doubled], Vascular Disease, Age 65–74, Female or CHA2DS2-VASc score. Also, the risk of bleeding should be considered, and for this purpose the Hypertension, Abnormal liver/renal function, Stroke history, Bleeding history or predisposition, Labile INR, Elderly, Drug/alcohol usage or HAS-BLED scoring system is used. In the patient whose case we have described, in addition to cryoablation of the pulmonary veins, an occluder of the left atrial appendage (LAAO) was placed in the same act.