Atrial fibrillation

 

The assessment of the thrombosis risk in patients with atrial fibrillation has not been prospectively validated using any specific criteria. Some observational studies propose that simply interrupting warfarin has a low incidence of post operative thrombosis1, but others have used a risk stratification based on the CHADS2 score to identify high risk patients2; patients with  score <3 have a low risk of thrombosis and those with a score of 5 or 6 are at high risk. One limitation of this stratification is that individual factors may strongly influence risk, for example a patient with a prior stroke could have a score of only 2 but should be regarded as high risk.

 

Risk of Thromboembolism With Short-term Interruption of Warfarin Therapy .  David A. Garcia, MD; Susan Regan, PhD; Lori E. Henault, MPH; Ashish Upadhyay, MD; Jaclyn Baker, MD; Mohamed Othman, MD; Elaine M. Hylek, MD, MPH Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use. Arch Intern Med. 2008:168;:63-69.

 
Periprocedural Anticoagulation Management of Patients With Nonvalvular Atrial Fibrillation. Waldemar E. Wysokinski, et al  Mayo Clinic Proceedings 2008: 83; 639-645,