2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary


Posted: 2021-11-13 20:00:00
Thromb Haemost . 2021 Nov 13. doi: 10.1055/s-0041-1739411. Online ahead of print. Tze-Fan Chao 1 2 , Boyoung Joung 3 , Yoshihide Takahashi 4 , Toon Wei Lim 5 , Eue-Keun Choi 6 , Yi-Hsin Chan 7 8 7 , Yutao Guo 9 , Charn Sriratanasathavorn 10 , Seil Oh 6 , Ken Okumura 11 , Gregory Y H Lip 12 13 Affiliations Expand Affiliations 1 Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 2 Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. 3 Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 4 The Department of Advanced Arrhythmia Research, Tokyo Medical and Dental University, Tokyo, Japan. 5 National University Heart Centre, National University Hospital, Singapore. 6 Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 7 Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. 8 College of Medicine, Chang Gung University, Taoyuan, Taiwan. 9 Pulmonary Vessel and Thrombotic Disease, Chinese PLA General Hospital, Beijing, China. 10 Her Majesty Cardiac Center, Siriraj, Thailand. 11 Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan. 12 Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, United Kingdom. 13 Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Item in Clipboard Tze-Fan Chao et al. Thromb Haemost. 2021. Show details Display options Display options Format Thromb Haemost . 2021 Nov 13. doi: 10.1055/s-0041-1739411. Online ahead of print. Authors Tze-Fan Chao 1 2 , Boyoung Joung 3 , Yoshihide Takahashi 4 , Toon Wei Lim 5 , Eue-Keun Choi 6 , Yi-Hsin Chan 7 8 7 , Yutao Guo 9 , Charn Sriratanasathavorn 10 , Seil Oh 6 , Ken Okumura 11 , Gregory Y H Lip 12 13 Affiliations 1 Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 2 Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. 3 Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 4 The Department of Advanced Arrhythmia Research, Tokyo Medical and Dental University, Tokyo, Japan. 5 National University Heart Centre, National University Hospital, Singapore. 6 Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 7 Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. 8 College of Medicine, Chang Gung University, Taoyuan, Taiwan. 9 Pulmonary Vessel and Thrombotic Disease, Chinese PLA General Hospital, Beijing, China. 10 Her Majesty Cardiac Center, Siriraj, Thailand. 11 Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan. 12 Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, United Kingdom. 13 Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Item in Clipboard CiteDisplay options Display options Format Abstract 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. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Conflict of interest statement B.J.: Served as a speaker for Bayer, BMS/Pfizer, Medtronic, and Daiichi-Sankyo and received research funds from Samjin, Medtronic, and Abbott. No fees have been received directly or personally. Y.T.: Research grants from Medtronic Japan, Boston Scientific, Japan Lifeline, WIN International, Abbott and Biosense-Webster, and speaker honoraria from Abbott and Biosense-Webster. G.Y. H. L.: Consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, and Daiichi-Sankyo. No fees are received personally. The other authors report no conflict of interest. [x] Cite Copy Format: Send To [x]

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