[Stroke and other thromboembolic complications of atrial fibrillation. Part VI. Choice of optimal approach and drugs for prevention of stroke].

In part VI of a series of papers on epidemiology and drug prevention of stroke and other thromboembolic complications of atrial fibrillation the authors analyze data of randomized trials comparing various approaches to the treatment of atrial fibrillation: cardioversion with subsequent use of antiarrhythmic drugs for maintenance of sinus rhythm and control of rate of ventricular rhythm with obligatory concomitant use of anticoagulants. Approach aimed at sinus rhythm maintenance by means of repetitive cardioversions and long term antiarrhythmic therapy has not been associated with lowering of mortality, rates of stroke or other thromboembolic complications. The use of antithrombotic drugs represent a sole reliable method of stroke prevention in patients with persistent and chronic AF. The paper contains consideration of indications for prescription of warfarin and aspirin to these patients.