Thromb Haemost 2017; 117(07): 1230-1239
DOI: 10.1160/TH16-11-0876
60th Anniversary
Schattauer GmbH

Stroke prevention in atrial fibrillation: Past, present and future

Comparing the guidelines and practical decision-making
Gregory Y.H. Lip
1   Institute of Cardiovascular Science, University of Birmingham, Birmingham, UK
2   Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
3   School of Medicine, Belgrade University, Belgrade, Serbia
Ben Freedman
4   Heart Research Institute, Charles Perkins Centre, Sydney Medical School, University of Sydney, Sydney, Australia
5   Department of Cardiology and Anzac Research Institute, Concord Hospital, University of Sydney, Australia
Raffaele De Caterina
6   G. d’Annunzio” University and Center of Excellence on Aging – CeSI-Met, Chieti, Italy
Tatjana S. Potpara
3   School of Medicine, Belgrade University, Belgrade, Serbia
7   Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia
› Author Affiliations
Further Information

Publication History

Received: 22 November 2016

Accepted after minor revision: 02 January 2017

Publication Date:
08 November 2017 (online)


Concepts and our approaches to stroke prevention in atrial fibrillation (AF) have changed markedly over the last decade. There has been an evolution over the approach to stroke and bleeding risk assessment, as well as new treatment options. An increasing awareness of AF has led to calls to improve the detection of and population screening for AF. Stroke and bleeding risk assessment continues to evolve, and the ongoing debate on balance between simplicity and practicality, against precision medicine will continue. In this review article, we provide an overview of past, present and the (likely) future concepts and approaches to stroke prevention in AF. We propose three simple steps (the Birmingham ‘3-step’) that offers a practical management pathway to help streamline and simplify decision-making for stroke prevention in patients with AF.

Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.