Methods of prevention of thromboembolic complications in patients with atrial fibrillation

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The analysis of studies devoted to methods of prevention of thromboembolic complications in patients with various forms of atrial fibrillation is presented. The main focus was on pharmacological methods for the prevention of ischemic stroke and systemic thromboembolism. The basic principles of choosing the optimal anticoagulant therapy, taking into account the risk factors for thromboembolic complications and bleeding, as well as patients’ polymorbidity, are outlined. The main indications for the use of oral anticoagulants are described. An algorithm for choosing the optimal anticoagulant therapy in patients with atrial fibrillation after percutaneous coronary intervention with the acute coronary syndrome and stable coronary artery disease, as well as with catheter ablation, has been demonstrated. Non - pharmacological methods for the prevention of thromboembolic complications are highlighted with a description of the main indications for implantation of occluders in the left atrial appendage, its surgical occlusion, or isolation.

Full Text

Restricted Access

About the authors

M. B Patsenko

General Military Medical Directorate of the Ministry of Defense of the Russian Federation; the S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Moscow, Russia

V. I Steklov

The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation; the S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: vsteklov@yandex.ru
Moscow, Russia

S. A Ivanov

12th Consultative and Diagnostic Center of the Ministry of Defense of the Russian Federation

Moscow, Russia

Yu. A Danilov

12th Consultative and Diagnostic Center of the Ministry of Defense of the Russian Federation

Moscow, Russia

N. R Nugaeva

the S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Moscow, Russia

References

  1. Антитромботическая терапия в кардиологии / Под ред. Е.П.Панченко. - М.: Ремедиум, 2019. - 255 с.
  2. Евразийские клинические рекомендации по диагностике и лечению фибрилляции предсердий. - 2019. // URL: http://cardio-eur. asia/media/files/clinical_recommendations/recommendations_diagnosis_and_treatment_of _atrial_fibrillation_2019_rus.pdf (дата обращения: 22.02.2021).
  3. Кадырова М.В., Ильина М.В., Арбекова П.В., Степанова Ю.А. Чреспищеводная эхокардиография: методика, показания, возможности // Медицинская визуализация. - 2018. - Т. 22, № 2. - С. 25-46.
  4. Кобалава Ж.Д., Лазарев П.В., Федорова Д.Н. Когнитивная дисфункция на фоне фибрилляции предсердий: клинико-патогенетические ассоциации, диагностика и профилактика, аспекты применения антикоагулянтной терапии // Кардиология. - 2019. - Т. 59, № 10. - С. 66-77.
  5. Колбин А.С., Мосикян Б.А., Татарский Б.А. Социально-экономическое бремя фибрилляции предсердий в России: динамика за 7 лет (2010-2017 годы) // Вестн. аритмологии. - 2018. - № 92. - C. 42-48.
  6. Крайнюков П.Е., Серговенцев, А.А., Стеклов В.И. и др. Актуальные вопросы экспертизы профессиональной пригодности пациентов с высококурабельными аритмиями // Анналы аритмологии. - 2015. - Т. 12, № 3. - С. 174-182.
  7. Ревишвили А.Ш., Шляхто Е.В., Попов С.В. и др. Клинические рекомендации по проведению электрофизиологических исследований, катетерной абляции и применению имплантируемых антиаритмических устройств. - М.: ВНОА, 2017. - 701 с.
  8. Фибрилляция и трепетание предсердий: Клинические рекомендации. - М., 2020. - 185 с.
  9. Филатов А.Г., Тарашвили Э.Г. Эпидемиология и социальная значимость фибрилляции предсердий // Анналы аритмологии. - 2012. - № 2. - С. 5-13.
  10. Baran J., Stec S., Pilichowska-Paszkiet E. et al. Intracardiac echocardioraphy for detection of thrombus in the left atrial appendage: comparison with transesophageal echocardiography in patients undergoing ablation for atrial fibrillation: the Action Ice I Study // Circ. Arrhythm. Electrophysiol. - 2013. - Vol. 6, N 6. - Р. 1074-1081.
  11. Bjоrck F., Renlund H., Lip G.Y. et al. Outcomes in a Warfarin-Treated Population With Atrial Fibrillation // JAMA Cardiol. - 2016. - Vol. 1, N 2. - Р. 172-180.
  12. ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS // Europ. Heart J. - 2016. - Vol. 37, N 38. - Р. 2893-2962.
  13. Giannandrea D., Caponi C., Mengoni A. et al. Intravenous thrombolysis in stroke after dabigatran reversal with idarucizumab: case series and systematic review // J. Neurol. Neurosurg. Psychiatry. - 2019. - Vol. 90, N 5. - Р. 619-623.
  14. Hansen M.L., Jepsen R.M., Olesen J.B. et al. Thromboembolic risk in 16 274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy // Europace. - 2015. - Vol. 17, N 1. - Р. 18-23.
  15. Henrik V., Peter B.N., Sоren P.H. et al. Atrial flutter and thromboembolic risk: a systematic review // Heart. - 2015. - Vol. 101, N 18. - Р. 1446-1455.
  16. Hijazi Z., Oldgren J. Lindback J. et al. ARISTOTLE and RE-LY Investigators. The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study // Lancet. - 2016. - Vol. 387, N 10035. - Р. 2302-2311.
  17. Hong K.S., Kwon S.U., Lee S.H. et al. Rivaroxaban vs Warfarin Sodium in the UltraEarly Period After Atrial Fibrillation-Related Mild Ischemic Stroke: A Randomized Clinical Trial // JAMA Neurol. - 2017. - Vol. 74, N 10. - Р. 1206-1215.
  18. Kim I.S., Kim H.J., Kim T.H. et al. Appropriate doses of non-vitamin K antagonist oral anticoagulants in high-risk subgroups with atrial fibrillation: Systematic review and meta-analysis // J. Cardiol. - 2018. - Vol. 72, N 4. - Р. 284-291.
  19. Koskinas K.C., Rаber L., Zanchin T. et al. Duration of Triple Antithrombotic Therapy and Outcomes Among Patients Undergoing Percutaneous Coronary Intervention // JACC Cardiovasc. Interv. - 2016. - Vol. 9, N 14. - Р. 1473-1483.
  20. Lopes R.D., Heizer G., Aronson R. et al. Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation // N. Engl. J. Med. - 2019. - Vol. 380, N 16. - Р. 1509-1524.
  21. Luigi D.B., David C., Karl G.H. Rationale and design of AXAFA-AFNET 5: an investigator-initiated, randomized, open, blinded outcome assessment, multi-centre trial to comparing continuous apixaban to vitamin K antagonists in patients undergoing atrial fibrillation catheter ablation // Europace. - 2017. - Vol. 19, N 1. - Р. 132-138.
  22. Murthy S.B., Gupta A., Merkler A.E. et al. Restarting Anticoagulant Therapy After Intracranial Hemorrhage: A Systematic Review and Meta-Analysis // Stroke. - 2017. - Vol. 48, N 6. - Р. 1594-1600.
  23. Noseworthy P.A., Yao X., Shah N.D., Gersh B.J. Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and valvular heart disease // Int. J. Cardiol. - 2016. - Vol. 209. - P. 181-183.
  24. Nuotio I., Hartikainen J.E., Gronberg T. et al. Time to cardioversion for acute atrial fibrillation and thromboembolic complications // JAMA. - 2014. - Vol. 312, N 6. - Р. 647-649.
  25. Pollack C.V. Coagulation assessment with the new generation of oral anticoagulants // Emerg. Med. J. - 2016. - Vol. 33, N 6. - Р. 423-430.
  26. Renda G., Ricci F., Giugliano R.P., De Caterina R. Non-Vitamin K Antagonist oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease // J. Am. Coll. Cardiol. - 2017. - Vol. 69, N 11. - Р. 1363-1371.
  27. Sticherling C., Marin F., Birnie D. et al. Antithrombotic management in patients undergoing electrophysiological procedures: a European Heart Rhythm Association (EHRA) position document endorsed by the ESC Working Group Thrombosis, Heart Rhythm Society (HRS), and Asia Pacific Heart Rhythm Society (APHRS) // Europace. - 2015. - Vol. 17, N 8. - Р. 1197-1214.
  28. Van Laar C., Verberkmoes N.J., van Es H.W. et al. Thoracoscopic Left Atrial Appendage Clipping: A Multicenter Cohort Analysis // JACC Clin. Electrophysiol. - 2018. - Vol. 4, N 7. - Р. 893-901.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2021 Patsenko M.B., Steklov V.I., Ivanov S.A., Danilov Y.A., Nugaeva N.R.


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: № 01975 от 30.12.1992.