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

Journal

THROMBOSIS AND HAEMOSTASIS
Volume 122, Issue 1, Pages 20-47

Publisher

GEORG THIEME VERLAG KG
DOI: 10.1055/s-0041-1739411

Keywords

APHRS; atrial fibrillation; stroke prevention; consensus guidelines; executive summary

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The consensus on stroke prevention in atrial fibrillation by the APHRS in 2017 provided clinical guidance for healthcare professionals in the Asia-Pacific region. The updated 2021 focused update highlighted issues such as the AF Better Care pathway, advantages of NOACs for Asians, and the use of oral anticoagulants during the COVID-19 pandemic. While acknowledging gaps and uncertainties in current knowledge of AF, the importance of physician's decision-making in AF management was emphasized.
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.

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