Abstract
Fibrillation strengthens every few more cardioembolic ischemic strokes and is thus the cause of about 10 to 15% of all ischemic strokes. In the population over 80 years of age, cardioembolic ischemic strokes account for up to 40% of all ischemic strokes and will be an increasing burden due to the aging of the population.
Ischemic strokes in patients with atrial fibrillation have the most severe initial neurological deficit, the highest 90-day mortality, and the worst outcome in patients compared to other stroke subtypes. Approximately 70% of all ischemic strokes in patients with atrial fibrillation are due to a cardioembolization mechanism.
The diagnostic etiology of ischemic stroke cannot be performed on the basis of clinical examination alone. The article discusses the individual issues of ischemic stroke diagnosis in these patients - the length of monitoring rhythms, the use of biomarkers (D-dimer, BNP) and transcranial Doppler sonography.
The most beneficial strategy in the secondary prevention of ischemic stroke in patients with atrial fibrillation is anticoagulant therapy, but its risks are most significant for patients after a stroke. Additional parameters discussing the basic estimate of the risk of bleeding complications (eg using the HAS-BLED score), such as cerebral microhemorrhage or the pharmacogenetics of warfarin, and the question of the timing of the onset of anticoagulation after a stroke are also discussed.