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Editor's Note
September 29, 2021

It’s Time to Rethink (and Retrial) Our Framework for Stroke Prevention in Atrial Fibrillation

Author Affiliations
  • 1Department of Medicine, Stanford University School of Medicine, Stanford, California
  • 2Center for Digital Health, Stanford University School of Medicine, Stanford, California
  • 3Veterans Affairs Palo Alto Health Care System, Palo Alto, California
  • 4Associate Editor, JAMA Cardiology
JAMA Cardiol. 2021;6(12):1370. doi:10.1001/jamacardio.2021.3709

Risk stratification for stroke in individuals with atrial fibrillation (AF) is among the most challenging risk assessment problems in medicine. The disease is not binary, and measures of AF severity (burden, duration, or frequency) can rapidly fluctuate. Substrate markers associated with stroke (eg, left atrial size/structure/function, appendage emptying, or ejection fraction) may also fluctuate or be risk markers rather than causal factors. Ischemic stroke may not be from cardioembolism, even when AF is present.

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