Understanding the need to address challenges faced by Indian doctors in Stroke Prevention, leading Cardiologists across India formulated and published ‘Indian Consensus Guidance on Stroke Prevention in Atrial Fibrillation’ in association with the SPAF Academy India Experts (Stroke Prevention in Atrial Fibrillation). The consensus is published in the December 2015 edition of ‘Indian Heart Journal’. Stroke or a brain attack is the second largest cause of death in India. About If not managed appropriately 1 in 20 AF patients may develop stroke every year.
Atrial Fibrillation an irregular heart rhythm (arrhythmia) of up to 300 beats/min (4 times than normal), is a high risk factor for Stroke. Most common risk factors for Atrial Fibrillation include old age (>60 years), high blood pressure, heart failure, heart disorders, prior history of open heart surgery, thyroid disorder, diabetes, chronic lung disease, excessive alcohol intake etc. Atrial Fibrillation can cause a blood clot in the heart which may travel to a person’s brain, preventing normal blood flow and hence resulting in Stroke.
Immediate and proper management of Stroke is required to prevent death or paralysis. However, there are challenges in management of Stroke prevention in patients with Atrial Fibrillation, the most frequent being:
- Low diagnosis rate of Atrial Fibrillation, an indication of impending Stroke attack
- Management of Acute Coronary Syndrome(e.g. heart attack)
- Understand the differences in response of Asian and Western patients to blood thinners
- Matching the right drug to right patients from the new class of available blood thinners
Highlighting the need for Guidelines to address these challenges, Dr. Sundeep Mishra, Professor and Consultant Cardiologist, AIIMS, New Delhi and Editor of Indian Heart Journal said, “A Stroke incidence due to Atrial Fibrillation can be prevented if the symptoms are recognized and managed properly. Diagnosing Atrial Fibrillation and an impending stroke is not just a challenge in India but the world over, as this rhythm disorder of the heart is episodic in nature and remains silent for many years. In fact, for many patients, stroke could be the first presentation. Therefore, there was a need to develop guidelines to advice doctors how to manage Stroke in patients with Atrial Fibrillation.”
Explaining the formulation and essence of the Guidelines, Dr. Jamshed Dalal, Director, Center for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital, Mumbai said, “The Indian Consensus Guidance will help doctors with diagnosis and management procedures to prevent stroke in patients with Atrial Fibrillation. It provides recommendations for rational use of newer class of oral blood thinners (NOACs- Non-vitamin K antagonists) in Indian patients while providing evidence on NOACs in Asians including Indians. It gives a risk stratification of Stroke and Bleeding
The ‘Indian Consensus Guidance for Stroke Prevention in Atrial Fibrillation’ was framed by 14 leading Indian Cardiologists, hematologists and SPAF Academy India (subset of SPAF Academy Global) which is a 35 member steering committee of key Cardiologists, Neurologists, Haematologists across India.