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Atrial fibrillation is one of the most common causes of ischaemic stroke, especially among the elderly. Cardiogenic stroke accounts for approximately 15-25& of all ischaemic strokes, depending on different studies. About 1/3 of all ischaemic strokes have an unknown cause and it is estimated that paroxysmal atrial fibrillation contributes to cryptogenic ischaemic strokes. De novo atrial fibrillation accounts for even over 20& of ischaemic strokes. The number of patients with atrial fibrillation has probably increased due to the aging of the population and more precise diagnostic procedures. Detection of atrial fibrillation is of great importance because ischaemic stroke due to atrial fibrillation is characterized by a tendency to recurrence, worse prognosis, longer hospitalization and higher mortality. Atrial fibrillation remains undiagnosed in a large percentage of cases. Holter ECG monitoring is most often used for diagnostic purposes. However, the diagnostic process should also include long-term Holter ECG monitoring because atrial fibrillation is detected only in a small percentage of cases when 24-h ECG monitoring is used. Our paper stresses the fact that the diagnosis of atrial fibrillation, particularly de novo, is very important for further therapeutic treatment i.e. the use of anticoagulants i.e. both the antagonists of vitamin K and NOACs.
This article was published in the following journal.
Name: Wiadomosci lekarskie (Warsaw, Poland : 1960)
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Rapid, irregular atrial contractions caused by a block of electrical impulse conduction in the right atrium and a reentrant wave front traveling up the inter-atrial septum and down the right atrial free wall or vice versa. Unlike ATRIAL FIBRILLATION which is caused by abnormal impulse generation, typical atrial flutter is caused by abnormal impulse conduction. As in atrial fibrillation, patients with atrial flutter cannot effectively pump blood into the lower chambers of the heart (HEART VENTRICLES).
A THROMBIN inhibitor which acts by binding and blocking thrombogenic activity and the prevention of thrombus formation. It is used to reduce the risk of stroke and systemic EMBOLISM in patients with nonvalvular atrial fibrillation.
Long-term changes in the electrophysiological parameters and/or anatomical structures of the HEART ATRIA that result from prolonged changes in atrial rate, often associated with ATRIAL FIBRILLATION or long periods of intense EXERCISE.
A morpholine and thiophene derivative that functions as a FACTOR XA INHIBITOR and is used in the treatment and prevention of DEEP-VEIN THROMBOSIS and PULMONARY EMBOLISM. It is also used for the prevention of STROKE and systemic embolization in patients with non-valvular ATRIAL FIBRILLATION, and for the prevention of atherothrombotic events in patients after an ACUTE CORONARY SYNDROME.
A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666)
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