Previous cohort studies of atrial fibrillation (AF) patients showed those with intermittent AF had stroke rates similar to patients with sustained AF. Many elderly patients with recurrent intermittent AF have substantial rates of stroke and likely benefit from anticoagulation. High-risk patients with intermittent AF can be identified using the same clinical criteria that apply to patients with sustained AF.
However, recent anticoagulation trials found those with persistent/permenant AF have a higher risk of thromboembolic events and worse survival compared with paroxysmal AF. The benefits of non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin on efficacy and safety were similar in patients with permanent, persistent, and intermittent AF. |
