Stephen J. Schueler, M.D.

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Fibrillation of the Atria Anticoagulation

Most people who have atrial fibrillation require treatment with blood thinners, called anticoagulants. Atrial fibrillation can cause blood clots to form in the chambers of the heart. The clot can break off of the wall of the heart chamber, where it is carried through arteries by the bloodstream. As the artery becomes smaller and smaller, eventually the clot becomes stuck in the artery. This completely stops blood from flowing to the tissues supplied by the artery. The most common place that this occurs is in the brain, where the clot causes a stroke. The anticoagulant medications reduce the risk of clot formation.

Initial anticoagulant medications use to treat atrial fibrillation include:

The anticoagulant effects of warfarin are delayed. Heparin or low molecular weight heparin are started at the same time as warfarin, in order to provide anticoagulation until warfarin becomes active. The heparin or low molecular weight heparin are discontinued once warfarin becomes active.

Warfarin should be avoided in those with:

Alternatives to long-term treatment with warfarin include:

Regular monitoring of prothrombin times is essential for any patient taking warfarin. Most experts recommend a target INR value between 2 and 3. Initial therapy requires daily prothrombin times until stabilized, then 2-3 times per week for 1-2 weeks. Regular prothrombin times should be obtained every 4-8 weeks thereafter.

Continue to Fibrillation of the Atria Cardioversion

Last Updated: Dec 1, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Fibrillation of the Atria References
  1. Alchaghouri S. Atrial fibrillation. 2: Management. Hosp Med. 2004 Sep;65(9):546-52. [15449492]
  2. Freestone B, Kamath S, Lip G. Atrial fibrillation (acute). Clin Evid. 2003 Jun;(9):61-71. [15366136]
  3. Johnson J, Napier KT. Atrial fibrillation: new theories, emerging treatments. JAAPA. 2005 Jun;18(6):36-41. [15977854]
  4. Leonardi M, Bissett J. Prevention of atrial fibrillation. Curr Opin Cardiol. 2005 Sep;20(5):417-23. [16093761]
  5. Mead GE, Flapan AD, Elder AT. Electrical cardioversion for atrial fibrillation and flutter. Cochrane Database Syst Rev. 2002;(1):CD002903. [11869642]
  6. Veenhuyzen GD, Simpson CS, Abdollah H. Atrial fibrillation. CMAJ. 2004 Sep 28;171(7):755-60. [15451840]
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