New Guidelines Out on Use of Anti-Clotting Therapy

Groups say stroke risk should be main determinant in treating patients with atrial fibrillation

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FRIDAY, Aug. 4, 2006 (HealthDay News) -- New guidelines say that stroke risk factors should be the main consideration in determining whether anti-clotting therapy is used to treat patients with a form of irregular heartbeat called atrial fibrillation (AF).

The revised procedures were released this week by the American College of Cardiology, American Heart Association, and the European Society of Cardiology.

The previous guidelines recommended using several patient characteristics -- age, gender, heart disease risk and concurrent conditions -- in deciding whether to use anti-clotting therapy.

"We focused on stroke risk (in the revised guidelines) because AF is associated with increased long-term risk for stroke. About 15 percent to 20 percent of strokes occur in people with AF, and those strokes are especially large and disabling," Dr. Valentin Fuster, co-chairman of the guidelines writing committee, said in a prepared statement.

"Incorporating existing recommendations on anti-clotting therapy from the stroke primary prevention guidelines will streamline patient care and make recommendations clearer for physicians," said Fuster, director of the Mount Sinai Cardiovascular Institute in New York City.

Atrial fibrillation is the most common kind of heart rhythm disturbance and increases the risk for stroke, heart failure and all causes of death. AF can cause blood to pool and clot in the heart. If a clot leaves the heart and lodges in an artery of the brain, it can cause a stroke.

The revised guidelines also advise that AF patients with no stroke risk factors should use daily aspirin therapy to guard against blood clots.

The committee also decided that catheter ablation (which uses radiofrequency energy to correct irregular heartbeat) is "a reasonable alternative to drug therapy to treat AF in patients with little or no left atrial enlargement, and in whom drug treatments did not stop the rhythm disturbance," Fuster said.

More information

The U.S. National Library of Medicine has more about atrial fibrillation.

SOURCE: American College of Cardiology, American Heart Association, European Society of Cardiology, news release, Aug. 2, 2006


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