Clinical decisions for appropriate management of patients with atrial fibrillation

The management of patients with atrial fibrillation (AF) requires intricate clinical decision-making to optimize outcomes. In everyday clinical practice, physicians undergo difficult choices to better manage patients with AF. They need to balance thromboembolic and bleeding risk to focus on patients...

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Bibliographic Details
Published inPanminerva medica Vol. 66; no. 3; p. 266
Main Authors Boriani, Giuseppe, Bonini, Niccolò, Imberti, Jacopo F, Vitolo, Marco, Gerra, Luigi, Mantovani, Marta, Serafini, Kevin, Birtolo, Chiara, Tartaglia, Enrico, Mei, Davide A
Format Journal Article
LanguageEnglish
Published Italy 01.09.2024
Subjects
Administration, Oral
Anticoagulants - therapeutic use
Atrial Fibrillation - complications
Atrial Fibrillation - diagnosis
Atrial Fibrillation - therapy
Clinical Decision-Making
Comorbidity
Hemorrhage - chemically induced
Hemorrhage - etiology
Humans
Risk Assessment
Risk Factors
Stroke - diagnosis
Stroke - etiology
Stroke - therapy
Thromboembolism - etiology
Thromboembolism - prevention & control
Treatment Outcome
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Summary:The management of patients with atrial fibrillation (AF) requires intricate clinical decision-making to optimize outcomes. In everyday clinical practice, physicians undergo difficult choices to better manage patients with AF. They need to balance thromboembolic and bleeding risk to focus on patients' symptoms and to manage a variety of multiple comorbidities. In this review, we aimed to explore the multifaceted dimensions of clinical decision-making in AF patients, encompassing the definition and diagnosis of clinical AF, stroke risk stratification, oral anticoagulant therapy selection, consideration of bleeding risk, and the ongoing debate between rhythm and rate control strategies. We will also focus on possible grey zones for the management of AF patients. In navigating this intricate landscape, clinicians must reconcile the dynamic interplay of patient-specific factors, evolving guidelines, and emerging therapies. The review underscores the need for personalized, evidence-based clinical decision-making to tailor interventions for optimal outcomes according to specific AF patient profiles.
ISSN:1827-1898
DOI:10.23736/S0031-0808.24.05114-0