Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Thromb Haemost. 2022 Jan;122(1):20-47. doi: 10.1055/s-0041-1739411. Epub 2021 Nov 13.
The consensus of the Asia Pacific Heart Rhythm Society (APHRS) on stroke prevention in atrial fibrillation (AF) has been published in 2017 which provided useful clinical guidance for cardiologists, neurologists, geriatricians, and general practitioners in the Asia-Pacific region. In these years, many important new data regarding stroke prevention in AF were reported. The practice guidelines subcommittee members comprehensively reviewed updated information on stroke prevention in AF, and summarized them in this 2021 focused update of the 2017 consensus guidelines of the APHRS on stroke prevention in AF. We highlighted and focused on several issues, including the importance of the AF Better Care pathway, the advantages of non-vitamin K antagonist oral anticoagulants (NOACs) for Asians, the considerations of use of NOACs for Asian AF patients with single one stroke risk factor beyond gender, the role of lifestyle factors on stroke risk, the use of oral anticoagulants during the "coronavirus disease 2019" pandemic, etc. 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.
2017 年发布的《亚太心律学会心房颤动卒中预防共识》为亚太地区的心脏病专家、神经科医生、老年病学家和全科医生提供了有用的临床指导。近年来,有关心房颤动卒中预防的许多重要新数据被报道。实践指南小组委员会成员全面审查了心房颤动卒中预防的最新信息,并在这份 2021 年对 2017 年亚太心律学会心房颤动卒中预防共识指南的重点更新中进行了总结。我们强调并关注了几个问题,包括心房颤动更好护理路径的重要性、非维生素 K 拮抗剂口服抗凝剂(NOACs)对亚洲人的优势、考虑在亚洲 AF 患者中风风险因素仅为性别以外的单一因素时使用 NOACs、生活方式因素对中风风险的影响、在“COVID-19”大流行期间使用口服抗凝剂等。我们充分意识到,在当前对心房颤动的认识中存在差距、未解决的问题以及许多不确定和有争议的领域,医生的决策仍然是心房颤动管理中最重要的因素。