简介:Strokeisthemostcommoncomplicationofatrialfibrillation(AF).GuidelinesrecommendanticoagulanttreatmentinpatientswithCHA2DS2VAScscoresof>2.RegistrydatasuggeststhatalmosthalfofpatientswhoshouldbeontherapeuticanticoagulationforstrokepreventioninAF(SPAF)arenot.Warfarinandmorerecentlydevelopedagents,the"novelanticoagulants"(NOACs)reducetheriskofembolicstrokes.Inaddition,theNOACsalsoreduceintracranialhemorrhage(ICH)byover50%comparedtowarfarin.Anticoagulationandbridgingstrategiesinvolvingcardioversion,catheterablation,andinvasive/surgicalproceduresarereviewed.ThedevelopmentofreversalagentsforNOACsandtheintroductionofleftatrialappendageoccludingdeviceswillevolvetheuseofnewerstrategiesforpreventingstrokeinhighriskAFpatients.