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Atrial fibrillation (AF) is the most common significnat cardiac arrhythmia and is a leading cause of stroke in the elderly. Stroke from AF is embolic. Numerous clinical trials have demonstrated that anticoagulation with warfarin is the most effective method of stroke prevention. However, anticoagulation treatment is associated with a higher requency of hemmorhagic complications and is more burdensome to admionister and monitor. It is often difficult to decide which patients with atrial fibrillation require systemic anticoagulation for stroke prevention. For those with frequent paroxysmal, persistent or chronic AF, two risk stratification schemes (seen below) have been developed based on the SPAF and AFI trials. These schemes provide an estimate pf the patients stroke risk and a guide to anticoagulation treatment.
This is the risk stratification scheme based on the SPAF trial. Please select from one of the following:
Age less than 65
Age 65 - 75
Age 75 or greater, previous stroke, TIA or systemic embolic event, DM, hypertension, history of CHF or left ventricular systolic dysfunction
The CHAD score is a risk stratification scheme based on the ATI and SPAF trials. Please select all that apply then click calculate.
History of a stroke or TIA
Diabetes
Hypertension
History of CHF
Age > 75
Atrial flutter
AF < 48 hours duration
AF of unknown or > 48 hours duration who are candidates for cardioversion
AF after cardiac surgery
AF requiring emergency cardioversion
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