AF Information & Advice For Patients
AF-related stroke risk reduction
Anticoagulants are a medication taken to reduce the risk of stroke caused by AF. They work by slowing down the clotting process of the blood.
Warfarin is the oldest anticoagulant and has been tried and tested for decades. Warfarin works with vitamin K in the body to inhibit clotting, and because levels of vitamin K vary from week to week, regular blood tests are needed to check what are known as INR (International normalised ratio) levels which affect the dose of warfarin needed.
Since 2012, four so-called novel anticoagulants (NOACs) have been approved, namely dabigatran,rivaroxaban, apixaban and edoxaban. These work in a different way from warfarin and the daily dose is relatively constant compared with warfarin.
Heparin is an injectable anticoagulant which starts working very quickly and this is used on some patients during an operation. Heparin is not a viable alternative for home use because of its very short half-life.
Left atrial appendage occlusion (LAAO)
For those who are unable to tolerate anticoagulants for medical reasons, there is a procedure known as LAAO or Transcatheter Closure of the left atrial appendage. This closes totally or partially the small pouch off the heart (the LAA) in which clots can form. LAAO has comparable risk-prevention capability as anticoagulation.