Updated Guidelines for A-Fib Aim to Lower Stroke Risk


New guidelines for lessening stroke risk in people with atrial fibrillation (a-fib), a common heart rhythm disorder, were published in Circulation, the Journal of the American College of Cardiology, and HeartRhythm, according to the American Heart Association. Recommendations include the use of newer anticoagulants, called non-vitamin K oral anticoagulants (NOACs), over traditional blood thinners like warfarin.

Atrial fibrillation increases stroke risk, often without producing symptoms, by leading to blood clots that can block arteries and impede blood flow to the brain. Anticoagulants — blood-thinning medications — are used to mitigate this risk. NOACs, which include dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa), for example, are recommended except in people with moderate-to-severe mitral stenosis (narrowing of the mitral heart valve) or an artificial heart valve.

Other updated guidelines focus on weight loss in people with a-fib who are overweight or obese, and the use of reversal agents (drugs to reverse the effect of NOACs) in cases of severe bleeding or when an emergency surgical procedure is needed. The guidelines also suggest that non-vitamin K oral anticoagulants could be beneficial in patients at lower risk of stroke, but there’s not enough evidence to make that recommendation right now.

Sourced from: Circulation