Atrial Fibrillation: A Clinical Review and Comparison of Warfarin versus Dabigatran for Anticoagulation Therapy Public Deposited

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  • February 26, 2019
Creator
  • Cowan, Richard
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Physician Assistant Program
Abstract
  • Atrial fibrillation (AF), or AFib, is the most commonly occurring type of cardiac arrhythmia. AF is commonly referred to as an “irregularly irregular” rhythm and is defined as a supraventricular tachyarrhythmia in which an irregular electrical impulse in the upper chambers (atria) of the heart produces an uncoordinated depolarization and thus an inefficient contraction of the atria. As a result, there is a reduction in cardiac output and potential for pooling of blood in the atria which increases the risk of clot formation and mortality from a cerebrovascular accident or pulmonary embolism. AFib is a public health concern that affects up to 6 million people in the United States and is associated with more than 130,000 deaths per year. It also costs the U.S. healthcare system nearly $6 billion per year. AF becomes more prevalent with age, and with the steadily increasing elderly population worldwide, prevention and treatment of this condition becomes more important clinically and economically. Due to the immense burden on the healthcare system, there have been many advances in surgical and pharmacological modalities for treatment AF, however long-term anticoagulation therapy for prevention of thromboembolism has remained a guideline recommended treatment for AF. The goal of this article is to review the clinical aspects of atrial fibrillation including prevalence, pathophysiology, diagnosis, and treatment, with a focus on comparing traditional anticoagulation therapy of Warfarin with the newer nonVitamin K anti-coagulant Dabigatran (Pradaxa). This article will also serve to review recently collected data from the VA Medical Center in regard to implementation of anticoagulation guidelines in the management of non-valvular AFib.
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Rights statement
  • In Copyright
Reviewer
  • Beal, Meg
  • Susann, Phillip
Degree
  • Master of Health Science
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
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Deposit record
  • 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e
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