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Atrial fibrillation and stroke: time for a shift towards personalised and precision medicine?
  1. Duncan Wilson,
  2. Teddy Y Wu
  1. Christchurch Hospital, Christchurch, New Zealand
  1. Correspondence to Dr Duncan Wilson, Christchurch Hospital, Christchurch, New Zealand; duncan.wilson{at}

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Mechanisms relating to thrombus formation in atrial fibrillation are poorly understood and may differ in patients established on anticoagulation.

Traditional teaching tells us thrombus formation in atrial fibrillation (AF) is caused by venous stasis due to a fibrillating left atrium. Indeed, this is often the line we tell our patients, perhaps miming a fibrillating heart with our hands. We try to quantify the risk of stroke using various tools, most often the CHA2DS2VASc but in doing so we may neglect to consider and manage other relevant stroke risk factors inside and outside of the heart.

Yaghi and colleagues present an analysis from the initiation of anticoagulation study.1 In this subanalysis, patients with AF who are established on anticoagulation have a higher risk …

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  • Contributors DW wrote the draft. TYW provided expert review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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