Pharmacologic and nonpharmacologic therapies for stroke prevention in nonvalvular atrial fibrillation

Jiangli Han, Jie Cheng, Nilesh Mathuria

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Thromboembolism is the crucial cause of ischemic stroke in patients with atrial fibrillation (AF). Anticoagulation therapy with vitamin K antagonists, such as warfarin, have been proven to be effective for stroke prevention in AF. Nonetheless, the use of warfarin may be limited due to increased risk of bleeding, the potential interaction with multiple foods and drugs, and the need for routine coagulation monitoring. Over the last decade anticoagulants, such as dabigatran and rivaroxaban, have been developed and have shown superiority compared to warfarin for preventing stroke in patients with nonvalvular AF in large randomized trials. In addition, on account of the risk of thrombus formation in the left atrial appendage (LAA), many nonpharmacologic approaches have been developed to reduce stroke risk in patients with AF who are not candidates for anticoagulant therapy. Surgical, epicardial, and endovascular techniques for LAA closure are being investigated currently. Both novel pharmacotherapy and nonpharmacologic approaches for stroke prevention will be detailed in this review.

Original languageEnglish (US)
Pages (from-to)887-896
Number of pages10
JournalPACE - Pacing and Clinical Electrophysiology
Issue number7
StatePublished - Jul 2012


  • Atrial fibrillation
  • new technology
  • pharmacology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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