Contemporary measures to reduce the risk of embolic events in patients with atrial fibrillation.

Atrial fibrillation is a common arrhythmia with significant risk of embolic events. Patients with atrial fibrillation should undergo a careful assessment using validated risk score calculators to estimate the risk of embolic events and the risk of bleeding. Patients deemed to be at a high risk for arterial thromboembolism should be advised to take an oral anticoagulant with a vitamin K antagonist or a target-specific oral anticoagulant unless contraindicated. These agents significantly reduce the risk of embolic events, but at the expense of a higher risk of bleeding. Antiplatelet agents do not confer the same degree of protection and their use should limited. When antithrombotic treatment is contraindicated, novel approaches such as left atrial appendage occlusion should be considered.