Stroke prevention and intracranial hemorrhage risk in atrial fibrillation management: A mini review

Abstract

This mini-review examines the management of atrial fibrillation (AF) in patients at high risk of bleeding, with a focus on stroke prevention and intracranial hemorrhage risk. Anticoagulant therapy is commonly advised for AF patients, but it can elevate the risk of intracranial hemorrhage in certain individuals prone to bleeding. Two primary perspectives for managing high-risk patients are discussed: adhering to strict anticoagulation therapy or opting for alternative treatments like left atrial appendage closure (LAAC) or aspirin. The benefits and drawbacks of each approach are evaluated, emphasizing the importance of a personalized management plan based on patient risk profiles, comorbidities, and preferences. Ongoing research, including artificial intelligence, advances in LAAC devices, and combination therapies, is explored to enhance stroke prevention and minimize bleeding risk in AF management. A multidisciplinary approach and continuous investigation are vital to achieving better patient outcomes and overall care in this context.