Atrial fibrillation with thrombotic complications. Justification of the diagnosis and treatment regimen according to evidence-based medicine (clinical case)

Background. The presence of atrial fibrillation (AF) in patients is associated with a twofold increased risk of all-cause mortality. This is caused not only by fibrillation itself, but also to comorbid pathology and complications of this arrhythmia. Stroke is the most important predictor of high mortality among patients with AF, which occurs 5–6 times more often than with sinus rhythm. Purpose – аnalysis of a clinical case of a patient with AF on the background of arterial hypertension to clarify the assessment of the effectiveness of the selected therapy and develop recommendations for an individual approach to the treatment of such patients. Materials and Methods. The clinical case of a 79-year-old woman who had complains of headache, weakness, and periodic irregular heartbeat. She was diagnosed with permanent AF where are shown her further course and complications. Results. A clinical case with newly diagnosed AF on the background of arterial hypertension with HF with preserved ejection fraction, complicated by multiple thromboembolism (ischemic stroke and acute thrombosis of the right brachial artery) is described. Conclusions. Diagnosis and systematic screening of AF, as well as timely assessment of stroke risk, are of paramount importance for the prognosis of patients, especially in older age groups. Today, the treatment of AF should be based on the CARE algorithm, which includes main components of therapy: C – comorbidities and risk factor management; A – avoid – prevention of stroke and thromboembolism; R – rate and rhythm control – reduction of symptoms by controlling rate and rhythm; E – evaluation and repeated dynamic evaluation. A key point in the management of patients with AF is to achieve high patient adherence to the prescribed treatment.