What are the AHA/ACC/HRS recommendations for antithrombotic therapy for patients with holiday heart syndrome (HHS)?

Updated: May 30, 2018
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jose M Dizon, MD  more...
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Answer

The AHA/ACC/HRS further recommends that antithrombotic therapy should be based on the risk of thromboembolism irrespective of whether the AF pattern is paroxysmal, persistent or permanent. [30]

In 2014, the American Heart Association (AHA) also issued joint guidelines with the American Stroke Association (ASA) for the primary prevention of stroke, which included specific recommendations for stroke prevention in patients with AF. The main advantage of the CHA2DS2-VASc score (range, 0-9) is that it provides significantly improved risk prediction for individuals at low to moderate risk compared with the CHADS(scores of 0 or 1), particularly for elderly women. [39]

The AHA/ACC/HRS recommendations for antithrombotic therapy in patients with AF, based on CHA2DS2-VASc scores, are as follows [30] :

  • NVAF and CHA 2DS 2-VASc score = 0: No antithrombotic therapy
  • NVAF and CHA 2DS 2-VASc score = 1: No antithrombotic therapy or oral antithrombotic therapy
  • Prior stroke, TIA or CHA 2DS 2-VASc Score ≥2: Oral antithrombotic therapy

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