Each year, hundreds of thousands of people in Latin America suffer a stroke, and it is expected that the number of strokes per year increases dramatically as the population ages. This is an epidemic that is beginning to emerge, requiring immediate action to avoid a crisis. Many of these patients die from a stroke; others are severely disabled, which is devastating not only for their lives, but also for their families and caregivers. Not surprisingly, the economic consequences of stroke are enormous, both for individuals and for health care systems.Atrial fibrillation (AF) -the most common sustained abnormality of heart rhythm- affects about 6 million people in Latin America. For example, in Brazil, it was estimated that approximately1.5 million patients living AF. Individuals with AF are at a fivefold increased risk of stroke compared with the general population. Furthermore, strokes related to AF are more severe and have poorer outcomes than strokes in patients without AF. Patients with AF are therefore an important target population for reducing the overall burden of stroke. This report aims to raise awareness among patients, policy makers, healthcare professionals and the general public that better knowledge and management of AF and better prevention of stroke are possible. However, greater investment in preventing stroke is needed, particularly in patients with AF. Coordinated action by governments of Latin American countries is urgently required to achieve earlier diagnosis and better management of AF and to reduce the risk of stroke in patients with AF. Implementation of the recommendations detailed in this report, at regional and national level, will be crucial.
Atrial fibrillation is the commonest sustained cardiac arrhythmia, and has a significant impact on morbidity and mortality. It is a leading cause of stroke, and suitable thromboprophylaxis should be considered in all patients. Treatment is tailored to the individual. This article will review the management strategies for patients with atrial fibrillation, and discuss the roles of primary, secondary, and tertiary care.
Previous research shows patients have unrealistic expectations of preventive medication and that many default long-term • Informed choice requires that patients understand the balance of benefit against the risk, but imparting such information is difficult • The focus groups showed the majority of participants had received very little or no information on the benefits or disadvantages • Younger patients were receptive to being involved in decision-making, others trusted the doctor to recommend appropriate medication • The preferred format is written text or graphics giving information specific to the individual
