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Workup for patients with atrial fibrillation 

Workup for patients with atrial fibrillation
Workup for patients with atrial fibrillation
Management of Atrial Fibrillation (Oxford Cardiology Library): A Practical Approach

Bart A. Mulder

and Isabelle C. Van Gelder


In the treatment of atrial fibrillation (AF) the workup is important as this is the basis for choosing treatment strategy and starting anticoagulation in the individual patient. Opportunistic screening is indicated in the elderly since AF is often asymptomatic and recent data showed that short episodes of AF are already associated with an increased risk of stroke. During anamnesis it is important to not only focus on symptoms but also on start (trigger), duration, and termination of AF. Identification of the underlying (heart) disease is the most important next step. By means of physical examination, laboratory analyses, electrocardiogram, echocardiogram, and cardiac stress test underlying (heart) disease can be identified and optimal therapy can be initiated. The prognosis of AF is mainly dependent on the treatment or reversal of these underlying diseases. The next step is to incorporate the underlying diseases into the CHA2DS2-VASc and HAS-BLED scores which are stroke and bleeding risk scores, respectively, and to start anticoagulation accordingly.

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