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Advances in the management of atrial fibrillation with a special focus on non-pharmacological approaches to prevent thromboembolism: a review of current recommendations
  1. Malini Riddle1,
  2. Richard McCallum2,
  3. Chandra Prakash Ojha2,
  4. Timir Kumar Paul3,
  5. Vineet Gupta4,
  6. David Alan Baran5,
  7. Bharat Ved Prakash6,
  8. Amogh Misra7,
  9. Adriana Camila Mares2,
  10. Moeen Abedin8,
  11. Archana Kedar9,
  12. Venkatachalam Mulukutla8,
  13. Ahmed Ibrahim2,
  14. Harsha Nagarajarao2
  1. 1 Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
  2. 2 Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
  3. 3 Internal Medicine, East Tennessee State University James H Quillen College of Medicine, Johnson City, Tennessee, USA
  4. 4 Department of Internal Medicine, University of California San Diego, La Jolla, California, USA
  5. 5 Cardiovascular Diseases, Sentara Healthcare Inc, Norfolk, Virginia, USA
  6. 6 Department of Medicine, Texas Tech University Health Sciences Center El Paso, Transmountain Campus, El Paso, Texas, USA
  7. 7 Department of Biochemistry, The University of Texas at Austin, Austin, Texas, USA
  8. 8 Division of Cardiology, University Medical Center of El Paso, El Paso, Texas, USA
  9. 9 Internal Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
  1. Correspondence to Dr Harsha Nagarajarao, Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA; Harsha.Nagarajarao{at}


Atrial fibrillation (AFIB) is the most common heart rhythm abnormality and is associated with significant morbidity and mortality. While the treatment of AFIB involves strategies of rate with or without rhythm control, it is also essential to strategize appropriate therapies to prevent thromboembolic complications arising from AFIB. Previously, anticoagulation was the main treatment option which exposed patients to higher than usual risk of bleeding. However, with the advent of new technology, novel therapeutic options aimed at surgical or percutaneous exclusion or occlusion of the left atrial appendage in preventing thromboembolic complications from AFIB have evolved. This review evaluates recent advances and therapeutic options in treating AFIB with a special focus on both surgical and percutaneous interventions which can reduce and/or eliminate thromboembolic complications of AFIB.

  • atrial appendage
  • atrial fibrillation
  • stroke
  • anticoagulants
  • cardiovascular diseases

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  • Contributors All authors were actively involved with their work on this manuscript. MR: design, drafting and editing of the manuscript. RMcC: project mentor, critical revision and editing of the manuscript. CPO: editing of the manuscript. TKP: editing of the manuscript. VG: editing and proofreading of the manuscript. DAB: editing and review of the manuscript. AM: editing of the manuscript. ACM: editing of the manuscript. MA: editing of the manuscript. AK: editing of the manuscript. VM: editing of the manuscript. BVP: editing of the manuscript. AI: editing of the manuscript. HSN: manuscript concept and design, drafting of themanuscript, editing and critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.