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  • Q&A with Australian Health Practitioners

    How are blood clots prevented for people undergoing treatment for atrial fibrillation?

    Related Topics
    Atrial Fibrillation Cardiology & Vascular Health
    • 1 answer
    • Dr Michael Davis
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    Dr Michael Davis

    Cardiologist (Heart Specialist)

    Electrophysiologist and pioneer in catheter ablation and in the management of atrial fibrillation. Expertise in arrhythmia device therapy, coronary care, echocardiography. View Profile

    Medications known as “anticoagulants” are used in atrial fibrillation, not just those undergoing treatment but also people who require no specific rhythm treatment. The need for these, and whether this should be short term around the time of the procedure or cardioversion, or lifelong is determined by estimation of the risk of stroke. This risk of blood clots, with its most serious consequence being stroke, is best determined by the CHA2DS2VASc score. Warfarin is the established agent but there are new anticoagulants which should be available on the Australian pharmaceutical benefits scheme soon which have some advantages (and some disadvantages) compared with warfarin. Aspirin gives little protection at all. 

    Finally, for a very few patients,  primarily those who have difficulties with anticoagulation, there are devices which can “occlude” the left atrial appendage and reduce the risk of stroke. This is an invasive procedure applicable to only a few patients.

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