In-Depth Review of Stroke Prevention in Patients with Non-Valvular Atrial Fibrillation

Stroke is a common complication of atrial fibrillation that leads to high morbidity. Anticoagulation therapy significantly reduces the risk of stroke in a selected group of patients. The decision to start anticoagulation needs to be balanced with bleeding risk. During the past years, multiple oral anticoagulation agents were proven to be as effective as warfarin in multiple randomized clinical trials. The superior benefits of these agents over warfarin are lower risk of intracranial bleeding, stable blood level and no need for frequent blood monitoring. The non-pharmacological approach for stroke prevention is undergoing development and only use in the clinical trials. If proven to be beneficial, it will have great impact for the patient who is contraindicated for anticoagulation therapy. The objective of this article is to review the most current options for stroke prevention in patients with non-valvular atrial fibrillation.