SYMPTOMS AND PROGNOSIS OF PATIENTS WITH A TRIAL-FIBRILLATION

Atrial fibrillation is alleged to be one of the most frequently occurr ing arrhythmia. Many patients with atrial fibrillation are asymptomati c. Others, however, complain of palpitations and paroxysmal atrial tac hycardias. And especially in patients with preexisting heart failure, atrial fibrillation can lead to a clear worsening of cardiac output. N ot only rheumatic but nonrheumatic atrial fibrillation as well are ass ociated with an increased risk of thromboembolic complications. Arteri al hypertension, a history of thromboembolism as well as signs of hear t failure are clinical parameters which additionally increase the risk of embolism. On the other hand, this increased risk does not hold tru e for younger patients with idiopathic atrial fibrillation and is also low in patients with only one additional risk factor. Thus, it would indeed be false to anticoagulate every patient with atrial fibrillatio n. In each case, a careful individual risk stratification including an extensive history and detailed clinical examination should be perform ed before deciding on antithrombotic therapy.