2017 consensus of the Asia Pacific Heart Rhythm Society on stroke prevention in atrial fibrillation

Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2‐fold increase in mortality and a 5‐fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF‐associated stro...

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Veröffentlicht in:Journal of arrhythmia Jg. 33; H. 4; S. 345 - 367
Hauptverfasser: Chiang, Chern‐En, Okumura, Ken, Zhang, Shu, Chao, Tze‐Fan, Siu, Chung‐Wah, Wei Lim, Toon, Saxena, Anil, Takahashi, Yoshihide, Siong Teo, Wee
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Japan John Wiley & Sons, Inc 01.08.2017
Elsevier
Wiley
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ISSN:1880-4276, 1883-2148
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Abstract Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2‐fold increase in mortality and a 5‐fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF‐associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF‐associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non‐vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques. The Asia Pacific Heart Rhythm Society (APHRS) aimed to update the available information, and appointed the Practice Guideline sub‐committee to write a consensus statement regarding stroke prevention in AF. The Practice Guidelines sub‐committee members comprehensively reviewed updated information on stroke prevention in AF, emphasizing data on NOACs from the Asia Pacific region, and summarized them in this 2017 Consensus of the Asia Pacific Heart Rhythm Society on Stroke Prevention in AF. This consensus includes details of the updated recommendations, along with their background and rationale, focusing on data from the Asia Pacific region. We hope this consensus can be a practical tool for cardiologists, neurologists, geriatricians, and general practitioners in this region. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician׳s decision remains the most important factor in the management of AF.
AbstractList Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques. The Asia Pacific Heart Rhythm Society (APHRS) aimed to update the available information, and appointed the Practice Guideline sub-committee to write a consensus statement regarding stroke prevention in AF. The Practice Guidelines sub-committee members comprehensively reviewed updated information on stroke prevention in AF, emphasizing data on NOACs from the Asia Pacific region, and summarized them in this 2017 Consensus of the Asia Pacific Heart Rhythm Society on Stroke Prevention in AF. This consensus includes details of the updated recommendations, along with their background and rationale, focusing on data from the Asia Pacific region. We hope this consensus can be a practical tool for cardiologists, neurologists, geriatricians, and general practitioners in this region. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician׳s decision remains the most important factor in the management of AF.
Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques. The Asia Pacific Heart Rhythm Society (APHRS) aimed to update the available information, and appointed the Practice Guideline sub-committee to write a consensus statement regarding stroke prevention in AF. The Practice Guidelines sub-committee members comprehensively reviewed updated information on stroke prevention in AF, emphasizing data on NOACs from the Asia Pacific region, and summarized them in this 2017 Consensus of the Asia Pacific Heart Rhythm Society on Stroke Prevention in AF. This consensus includes details of the updated recommendations, along with their background and rationale, focusing on data from the Asia Pacific region. We hope this consensus can be a practical tool for cardiologists, neurologists, geriatricians, and general practitioners in this region. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician׳s decision remains the most important factor in the management of AF.Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques. The Asia Pacific Heart Rhythm Society (APHRS) aimed to update the available information, and appointed the Practice Guideline sub-committee to write a consensus statement regarding stroke prevention in AF. The Practice Guidelines sub-committee members comprehensively reviewed updated information on stroke prevention in AF, emphasizing data on NOACs from the Asia Pacific region, and summarized them in this 2017 Consensus of the Asia Pacific Heart Rhythm Society on Stroke Prevention in AF. This consensus includes details of the updated recommendations, along with their background and rationale, focusing on data from the Asia Pacific region. We hope this consensus can be a practical tool for cardiologists, neurologists, geriatricians, and general practitioners in this region. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician׳s decision remains the most important factor in the management of AF.
Author Siu, Chung‐Wah
Saxena, Anil
Takahashi, Yoshihide
Chiang, Chern‐En
Wei Lim, Toon
Chao, Tze‐Fan
Siong Teo, Wee
Zhang, Shu
Okumura, Ken
AuthorAffiliation j National Heart Centre, Singapore
d Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
b Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan
c State Key Laboratory of Cardiovascular Disease, Fuwai Hospital; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People׳s Republic of China
e Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
h Cardiac Pacing & Electrophysiology Center, Fortis Escorts Heart Institute, New Delhi, India
g National University Heart Centre, National University Hospital, Singapore
f Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong, China
i Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
a General Clinical Research Center and Division of Cardiology, Taipei Veterans General Hospital
AuthorAffiliation_xml – name: c State Key Laboratory of Cardiovascular Disease, Fuwai Hospital; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People׳s Republic of China
– name: a General Clinical Research Center and Division of Cardiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
– name: b Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan
– name: j National Heart Centre, Singapore
– name: d Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
– name: g National University Heart Centre, National University Hospital, Singapore
– name: i Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
– name: h Cardiac Pacing & Electrophysiology Center, Fortis Escorts Heart Institute, New Delhi, India
– name: e Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
– name: f Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong, China
Author_xml – sequence: 1
  givenname: Chern‐En
  surname: Chiang
  fullname: Chiang, Chern‐En
  email: cechiang@vghtpe.gov.tw
– sequence: 2
  givenname: Ken
  surname: Okumura
  fullname: Okumura, Ken
– sequence: 3
  givenname: Shu
  surname: Zhang
  fullname: Zhang, Shu
– sequence: 4
  givenname: Tze‐Fan
  surname: Chao
  fullname: Chao, Tze‐Fan
– sequence: 5
  givenname: Chung‐Wah
  surname: Siu
  fullname: Siu, Chung‐Wah
– sequence: 6
  givenname: Toon
  surname: Wei Lim
  fullname: Wei Lim, Toon
– sequence: 7
  givenname: Anil
  surname: Saxena
  fullname: Saxena, Anil
– sequence: 8
  givenname: Yoshihide
  surname: Takahashi
  fullname: Takahashi, Yoshihide
– sequence: 9
  givenname: Wee
  surname: Siong Teo
  fullname: Siong Teo, Wee
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28765771$$D View this record in MEDLINE/PubMed
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2017 Japanese Heart Rhythm Society. Published by Elsevier B.V. 2017 Japanese Heart Rhythm Society
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Issue 4
Keywords Stroke
Anticoagulation
Vitamin K antagonist
Atrial fibrillation
Non-vitamin K antagonist oral anticoagulants
Language English
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Snippet Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2‐fold increase in mortality and a 5‐fold increase in stroke. The Asian population...
Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population...
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StartPage 345
SubjectTerms Age
Anticoagulants
Anticoagulation
Asian people
Atrial fibrillation
Cardiac arrhythmia
Cardiology
Diabetes
Disease prevention
Females
Guideline
Heart failure
Hypertension
Ischemia
Non-vitamin K antagonist oral anticoagulants
Patients
Risk factors
Stroke
Transient ischemic attack
Vitamin K antagonist
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Title 2017 consensus of the Asia Pacific Heart Rhythm Society on stroke prevention in atrial fibrillation
URI https://onlinelibrary.wiley.com/doi/abs/10.1016%2Fj.joa.2017.05.004
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Volume 33
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