DETEKSI DINI ATRIAL FIBRILASI UNTUK MENURUNKAN RISIKO STROKE
Abstract
Stroke is one of the major causes of death and contributes to loss of productivity in daily activities throughout the world. Every year it is estimated that there are 13,7 million new cases of stroke with a possibility of 1 in 4 people over 25 years will developing stroke. Stroke has various pathogenesis depending on the age at which the onset of stroke and the type of stroke. The increase in prevalence and mortality due to stroke has prompted many studies to examine stroke risk factors as well as early detection and management, including prevention. One common form of cardiac arrhythmia, is atrial fibrillation or AF, is one of the triggering factors for stroke with a five-fold risk. AF often does not manifest the symptoms in patients. Early detection of AF in all individuals, especially those at high risk of AF and stroke, is crucial to initiating early intervention and reducing the possibility of complications. Various devices have been developed to detect the occurrence of AF in asymptomatic and at-risk patients. This literature aims to explain how to detect early atrial fibrillation, including screening for AF symptoms, physical examination, ECG examination, use of technological devices, stratifying the risk of stroke in AF patients, and finally the prevention strategies for both AF and stroke.
References
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American Heart Association (2023) Lifestyle Strategies for Atrial Fibrillation, American Heart Association. Available at: https://www.heart.org/en/health-topics/atrial-fibrillation/treatment-and-prevention-of-atrial-fibrillation/prevention-strategies-for-atrial-fibrillation-afib-or-af.
American Stroke Association (2022) Lifestyle Changes to Prevent Stroke, American Heart Association. Available at: https://www.stroke.org/-/media/Stroke-Files/Lets-Talk-About-Stroke/Prevention/Lifestyle-Changes-to-Prevent-Stroke.pdf.
Banerjee, C. and Chimowitz, M.I. (2017) ‘Stroke Caused by Atherosclerosis of the Major Intracranial Arteries’, Circulation Research, 120(3), pp. 502–13. Available at: https://doi.org/10.1161/CIRCRESAHA.116.308441.
Botto, G.L. et al. (2021) ‘Impact of the Pattern of Atrial Fibrillation on Stroke Risk and Mortality’, Arrhythm Electrophysiol Rev, 10(2), pp. 68–76. Available at: https://doi.org/10.15420%2Faer.2021.01.
Brandes, A. et al. (2018) ‘Risk Factor Management in Atrial Fibrillation’, Arrhythm Electrophysiol Rev., 7(2), pp. 118–27. Available at: https://doi.org/10.15420%2Faer.2018.18.2.
CDC (2022) Prevent Stroke: What You Can Do, CDC. Available at: https://www.cdc.gov/stroke/prevention.htm.
Chao, T.-F. and Chen, S.-A. (2014) ‘Stroke Risk Predictor Scoring Systems in Atrial Fibrillation’, J Atr Fibrillation, 6(5). Available at: https://doi.org/10.4022%2Fjafib.998.
Djaya, A.M.F.M., Sjattar, E.L. and Majid, A. (2021) ‘Risk Stratification Schemes dalam Mendeteksi Stroke pada Pasien Atrial Fibrillation’, Jurnal Kesehatan Masyarakat, 11(2).
Endt, V.H.W. van der et al. (2022) ‘Comprehensive comparison of stroke risk score performance: a systematic review and meta-analysis among 6 267 728 patients with atrial fibrillation’, EP Europace, 24(11). Available at: https://doi.org/10.1093/europace/euac096.
Fan, Y.-Y. et al. (2019) ‘Diagnostic Performance of a Smart Device With Photoplethysmography Technology for Atrial Fibrillation Detection: Pilot Study (Pre-mAFA II Registry)’, JMIR Mhealth Uhealth, 7(3). Available at: https://doi.org/10.2196/11437.
Gibson, C.M. et al. (2023) ‘Does early detection of atrial fibrillation reduce the risk of thromboembolic events? Rationale and design of the Heartline study’, Am Heart J, 259, pp. 30–41. Available at: https://pubmed.ncbi.nlm.nih.gov/36642226/.
Goldberger, A.L., Goldberger, Z.D. and Shvilkin, A. (2024) Goldberger’s Clinical Electrocardiography. 10th edn. Philadelphia: Elsevier.
Hamad, A.K.S. (2021) ‘New Technologies for Detection and Management of Atrial Fibrillation’, J Saudi Heart Assoc, 33(2), pp. 169–76. Available at: https://doi.org/10.37616%2F2212-5043.1256.
Hindricks, G. et al. (2020) ‘2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS)’, European Heart Journal, 00, pp. 1–25.
Hoetama, E., Hermawan, B. and Sunia, I.G.M. (2016) ‘Diagnostic Scoring System for Atrial Fibrillation in Ischemic Stroke’, Jurnal Kardiologi Indonesia, 37(1), pp. 19–27.
Hyman, D.A. et al. (2019) ‘Risk Assessment of Stroke in Patients with Atrial Fibrillation: Current Shortcomings and Future Directions’, Cardiovascular Drugs and Therapy, 33, pp. 105–17. Available at: https://link.springer.com/article/10.1007/s10557-018-06849-7.
Ibrahim, F. and Murr, N. (2022) ‘Embolic Stroke’, StatPearls [Preprint]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK564351/.
Isakadze, N. et al. (2018) ‘Life’s Simple 7 Approach to Atrial Fibrillation Prevention’, J Atr Fibrillation, 11(3). Available at: https://doi.org/10.4022%2Fjafib.2051.
Kamel, H. et al. (2016) ‘Atrial Fibrillation and Mechanisms of Stroke’, Stroke, 47(3), pp. 895–900. Available at: https://www.ahajournals.org/doi/10.1161/STROKEAHA.115.012004.
Keach, J.W. et al. (2015) ‘Early detection of occult atrial fibrillation and stroke prevention’, Heart [Preprint]. Available at: 10.1136/heartjnl-2015-307588.
Kuriakose, D. and Xiao, Z. (2020) ‘Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives’, Int J Mol Sci, 21(20). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589849/.
Lalani, G.G. et al. (2012) ‘Atrial Conduction Slows Immediately Before the Onset of Human Atrial Fibrillation’, J Am Coll, 59(6), pp. 595–606. Available at: https://doi.org/10.1016/j.jacc.2011.10.879.
Lee, D.K. et al. (2005) ‘Lesion Patterns and Stroke Mechanism in Atherosclerotic Middle Cerebral Artery Disease’, Stroke, 36(12). Available at: https://doi.org/10.1161/01.STR.0000189999.19948.14.
Lindsay, M.P. et al. (2019) Global Stroke Fact Sheet 2019. World Stroke Organization. Available at: https://www.world-stroke.org/assets/downloads/WSO_Fact-sheet_15.01.2020.pdf.
Linz, D., Hermans, A. and Tieleman, R.G. (2021) ‘Early atrial fibrillation detection and the transition to comprehensive management’, EP Europace, 23. Available at: https://doi.org/10.1093/europace/euaa424.
M., B.J.J. et al. (2022) ‘Atrial fibrillation’, Nature Reviews Disease Primers, 8(21). Available at: https://www.nature.com/articles/s41572-022-00347-9.
Migdady, I., Russman, A. and Buletko, A.B. (2021) ‘Atrial Fibrillation and Ischemic Stroke: A Clinical Review’, Semin Neurol [Preprint]. Available at: https://doi.org/10.1055/s-0041-1726332.
Mosenzon, O. et al. (2023) ‘Diabetes and Stroke: What Are the Connections?’, J Stroke, 25(1), pp. 26–38. Available at: https://doi.org/10.5853%2Fjos.2022.02306.
Murphy, S.J. and Werring, D.J. (2020) ‘Stroke: causes and clinical features’, Medicine, 48(9), pp. 561–66. Available at: https://doi.org/10.1016%2Fj.mpmed.2020.06.002.
NICE (2021) Atrial fibrillation: diagnosis and management, NICE. Available at: https://www.nice.org.uk/guidance/ng196/chapter/Recommendations#detection-and-diagnosis.
Oladirana, O. and Nwos, I. (2019) ‘Stroke risk stratification in atrial fibrillation: a review of common risk factors’, J Community Hosp Intern Med Perspect, 9(2), pp. 112–120. Available at: https://doi.org/10.1080%2F20009666.2019.1593781.
Patel, M.R. et al. (2011) ‘Rivaroxaban versus warfarin in nonvalvular atrial fibrillation’, N Engl J Med, 365(10). Available at: https://doi.org/10.1056/nejmoa1009638.
Petty, B.G. (2020) Basic Electrocardiography. 2nd edn. Springer.
Piccini, J.P. et al. (2013) ‘Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K ant’, Circulation, 127(2). Available at: https://doi.org/10.1161/circulationaha.112.107128.
Rienstra, M. et al. (2012) ‘Symptoms and Functional Status of Patients with Atrial Fibrillation: State-of-the-Art and Future Research Opportunities’, Circulation, 125(23), pp. 2933–43. Available at: https://doi.org/10.1161%2FCIRCULATIONAHA.111.069450.
Salvadori, E. et al. (2021) ‘Comparison between Ischemic and Hemorrhagic Strokes in Functional Outcome at Discharge from an Intensive Rehabilitation Hospital’, Diagnostics, 11(1). Available at: https://doi.org/10.3390%2Fdiagnostics11010038.
Singer, D.E. et al. (2013) ‘A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score’, J Am Heart Assoc, 2(3). Available at: https://doi.org/10.1161/jaha.113.000250.
Smyt, A. et al. (2023) ‘Alcohol Intake as a Risk Factor for Acute Stroke’, Neurology, 100(2). Available at: https://doi.org/10.1212%2FWNL.0000000000201388.
Soliman, E.Z., Bhave, P.D. and Chen, L.Y. (2019) ‘Electrocardiographic Diagnosis of Atrial Arrhythmias’, JAMA Clinical Challenge [Preprint]. Available at: https://jamanetwork.com/journals/jama/article-abstract/2748482.
Streur, M. et al. (2018) ‘Atrial fibrillation symptom clusters and associated clinical characteristics and outcomes: A cross-sectional secondary data analysis’, Eur J Cardiovasc Nurs, 17(8). Available at: https://doi.org/10.1177/1474515118778445.
Streur, M. (2019) ‘Atrial Fibrillation Symptom Perception’, J Nurse Pract., 15(1), pp. 60–64. Available at: https://doi.org/10.1016%2Fj.nurpra.2018.08.015.
Svendsen, J.H. et al. (2021) ‘Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial’, Lancet [Preprint]. Available at: https://doi.org/10.1016/s0140-6736(21)01698-6.
Thompson, T.S. et al. (2014) ‘The effect of anxiety and depression on symptoms attributed to atrial fibrillation’, Pacing Clin Electrophysiol, 37(4), pp. 439–46. Available at: https://doi.org/10.1111/pace.12292.
Tomasdottir, M. et al. (2019) ‘Risk of ischemic stroke and utility of CHA2DS2-VASc score in women and men with atrial fibrillation’, Clinical Cardiology [Preprint]. Available at: https://doi.org/10.1002/clc.23257.
Verhoeven, J.I. et al. (2021) ‘Ambient air pollution and the risk of ischaemic and haemorrhagic stroke’, The Lancet Planetary Health, 5(8). Available at: https://doi.org/10.1016/S2542-5196(21)00145-5.
Alshehri, A.M. (2019) ‘Stroke in atrial fibrillation: Review of risk stratification and preventive therapy’, J Family Community Med, 26(2), pp. 92–7. Available at: https://doi.org/10.4103%2Fjfcm.JFCM_99_18.
American Heart Association (2023) Lifestyle Strategies for Atrial Fibrillation, American Heart Association. Available at: https://www.heart.org/en/health-topics/atrial-fibrillation/treatment-and-prevention-of-atrial-fibrillation/prevention-strategies-for-atrial-fibrillation-afib-or-af.
American Stroke Association (2022) Lifestyle Changes to Prevent Stroke, American Heart Association. Available at: https://www.stroke.org/-/media/Stroke-Files/Lets-Talk-About-Stroke/Prevention/Lifestyle-Changes-to-Prevent-Stroke.pdf.
Banerjee, C. and Chimowitz, M.I. (2017) ‘Stroke Caused by Atherosclerosis of the Major Intracranial Arteries’, Circulation Research, 120(3), pp. 502–13. Available at: https://doi.org/10.1161/CIRCRESAHA.116.308441.
Botto, G.L. et al. (2021) ‘Impact of the Pattern of Atrial Fibrillation on Stroke Risk and Mortality’, Arrhythm Electrophysiol Rev, 10(2), pp. 68–76. Available at: https://doi.org/10.15420%2Faer.2021.01.
Brandes, A. et al. (2018) ‘Risk Factor Management in Atrial Fibrillation’, Arrhythm Electrophysiol Rev., 7(2), pp. 118–27. Available at: https://doi.org/10.15420%2Faer.2018.18.2.
CDC (2022) Prevent Stroke: What You Can Do, CDC. Available at: https://www.cdc.gov/stroke/prevention.htm.
Chao, T.-F. and Chen, S.-A. (2014) ‘Stroke Risk Predictor Scoring Systems in Atrial Fibrillation’, J Atr Fibrillation, 6(5). Available at: https://doi.org/10.4022%2Fjafib.998.
Djaya, A.M.F.M., Sjattar, E.L. and Majid, A. (2021) ‘Risk Stratification Schemes dalam Mendeteksi Stroke pada Pasien Atrial Fibrillation’, Jurnal Kesehatan Masyarakat, 11(2).
Endt, V.H.W. van der et al. (2022) ‘Comprehensive comparison of stroke risk score performance: a systematic review and meta-analysis among 6 267 728 patients with atrial fibrillation’, EP Europace, 24(11). Available at: https://doi.org/10.1093/europace/euac096.
Fan, Y.-Y. et al. (2019) ‘Diagnostic Performance of a Smart Device With Photoplethysmography Technology for Atrial Fibrillation Detection: Pilot Study (Pre-mAFA II Registry)’, JMIR Mhealth Uhealth, 7(3). Available at: https://doi.org/10.2196/11437.
Gibson, C.M. et al. (2023) ‘Does early detection of atrial fibrillation reduce the risk of thromboembolic events? Rationale and design of the Heartline study’, Am Heart J, 259, pp. 30–41. Available at: https://pubmed.ncbi.nlm.nih.gov/36642226/.
Goldberger, A.L., Goldberger, Z.D. and Shvilkin, A. (2024) Goldberger’s Clinical Electrocardiography. 10th edn. Philadelphia: Elsevier.
Hamad, A.K.S. (2021) ‘New Technologies for Detection and Management of Atrial Fibrillation’, J Saudi Heart Assoc, 33(2), pp. 169–76. Available at: https://doi.org/10.37616%2F2212-5043.1256.
Hindricks, G. et al. (2020) ‘2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS)’, European Heart Journal, 00, pp. 1–25.
Hoetama, E., Hermawan, B. and Sunia, I.G.M. (2016) ‘Diagnostic Scoring System for Atrial Fibrillation in Ischemic Stroke’, Jurnal Kardiologi Indonesia, 37(1), pp. 19–27.
Hyman, D.A. et al. (2019) ‘Risk Assessment of Stroke in Patients with Atrial Fibrillation: Current Shortcomings and Future Directions’, Cardiovascular Drugs and Therapy, 33, pp. 105–17. Available at: https://link.springer.com/article/10.1007/s10557-018-06849-7.
Ibrahim, F. and Murr, N. (2022) ‘Embolic Stroke’, StatPearls [Preprint]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK564351/.
Isakadze, N. et al. (2018) ‘Life’s Simple 7 Approach to Atrial Fibrillation Prevention’, J Atr Fibrillation, 11(3). Available at: https://doi.org/10.4022%2Fjafib.2051.
Kamel, H. et al. (2016) ‘Atrial Fibrillation and Mechanisms of Stroke’, Stroke, 47(3), pp. 895–900. Available at: https://www.ahajournals.org/doi/10.1161/STROKEAHA.115.012004.
Keach, J.W. et al. (2015) ‘Early detection of occult atrial fibrillation and stroke prevention’, Heart [Preprint]. Available at: 10.1136/heartjnl-2015-307588.
Kuriakose, D. and Xiao, Z. (2020) ‘Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives’, Int J Mol Sci, 21(20). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589849/.
Lalani, G.G. et al. (2012) ‘Atrial Conduction Slows Immediately Before the Onset of Human Atrial Fibrillation’, J Am Coll, 59(6), pp. 595–606. Available at: https://doi.org/10.1016/j.jacc.2011.10.879.
Lee, D.K. et al. (2005) ‘Lesion Patterns and Stroke Mechanism in Atherosclerotic Middle Cerebral Artery Disease’, Stroke, 36(12). Available at: https://doi.org/10.1161/01.STR.0000189999.19948.14.
Lindsay, M.P. et al. (2019) Global Stroke Fact Sheet 2019. World Stroke Organization. Available at: https://www.world-stroke.org/assets/downloads/WSO_Fact-sheet_15.01.2020.pdf.
Linz, D., Hermans, A. and Tieleman, R.G. (2021) ‘Early atrial fibrillation detection and the transition to comprehensive management’, EP Europace, 23. Available at: https://doi.org/10.1093/europace/euaa424.
M., B.J.J. et al. (2022) ‘Atrial fibrillation’, Nature Reviews Disease Primers, 8(21). Available at: https://www.nature.com/articles/s41572-022-00347-9.
Migdady, I., Russman, A. and Buletko, A.B. (2021) ‘Atrial Fibrillation and Ischemic Stroke: A Clinical Review’, Semin Neurol [Preprint]. Available at: https://doi.org/10.1055/s-0041-1726332.
Mosenzon, O. et al. (2023) ‘Diabetes and Stroke: What Are the Connections?’, J Stroke, 25(1), pp. 26–38. Available at: https://doi.org/10.5853%2Fjos.2022.02306.
Murphy, S.J. and Werring, D.J. (2020) ‘Stroke: causes and clinical features’, Medicine, 48(9), pp. 561–66. Available at: https://doi.org/10.1016%2Fj.mpmed.2020.06.002.
NICE (2021) Atrial fibrillation: diagnosis and management, NICE. Available at: https://www.nice.org.uk/guidance/ng196/chapter/Recommendations#detection-and-diagnosis.
Oladirana, O. and Nwos, I. (2019) ‘Stroke risk stratification in atrial fibrillation: a review of common risk factors’, J Community Hosp Intern Med Perspect, 9(2), pp. 112–120. Available at: https://doi.org/10.1080%2F20009666.2019.1593781.
Patel, M.R. et al. (2011) ‘Rivaroxaban versus warfarin in nonvalvular atrial fibrillation’, N Engl J Med, 365(10). Available at: https://doi.org/10.1056/nejmoa1009638.
Petty, B.G. (2020) Basic Electrocardiography. 2nd edn. Springer.
Piccini, J.P. et al. (2013) ‘Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K ant’, Circulation, 127(2). Available at: https://doi.org/10.1161/circulationaha.112.107128.
Rienstra, M. et al. (2012) ‘Symptoms and Functional Status of Patients with Atrial Fibrillation: State-of-the-Art and Future Research Opportunities’, Circulation, 125(23), pp. 2933–43. Available at: https://doi.org/10.1161%2FCIRCULATIONAHA.111.069450.
Salvadori, E. et al. (2021) ‘Comparison between Ischemic and Hemorrhagic Strokes in Functional Outcome at Discharge from an Intensive Rehabilitation Hospital’, Diagnostics, 11(1). Available at: https://doi.org/10.3390%2Fdiagnostics11010038.
Singer, D.E. et al. (2013) ‘A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score’, J Am Heart Assoc, 2(3). Available at: https://doi.org/10.1161/jaha.113.000250.
Smyt, A. et al. (2023) ‘Alcohol Intake as a Risk Factor for Acute Stroke’, Neurology, 100(2). Available at: https://doi.org/10.1212%2FWNL.0000000000201388.
Soliman, E.Z., Bhave, P.D. and Chen, L.Y. (2019) ‘Electrocardiographic Diagnosis of Atrial Arrhythmias’, JAMA Clinical Challenge [Preprint]. Available at: https://jamanetwork.com/journals/jama/article-abstract/2748482.
Streur, M. et al. (2018) ‘Atrial fibrillation symptom clusters and associated clinical characteristics and outcomes: A cross-sectional secondary data analysis’, Eur J Cardiovasc Nurs, 17(8). Available at: https://doi.org/10.1177/1474515118778445.
Streur, M. (2019) ‘Atrial Fibrillation Symptom Perception’, J Nurse Pract., 15(1), pp. 60–64. Available at: https://doi.org/10.1016%2Fj.nurpra.2018.08.015.
Svendsen, J.H. et al. (2021) ‘Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial’, Lancet [Preprint]. Available at: https://doi.org/10.1016/s0140-6736(21)01698-6.
Thompson, T.S. et al. (2014) ‘The effect of anxiety and depression on symptoms attributed to atrial fibrillation’, Pacing Clin Electrophysiol, 37(4), pp. 439–46. Available at: https://doi.org/10.1111/pace.12292.
Tomasdottir, M. et al. (2019) ‘Risk of ischemic stroke and utility of CHA2DS2-VASc score in women and men with atrial fibrillation’, Clinical Cardiology [Preprint]. Available at: https://doi.org/10.1002/clc.23257.
Verhoeven, J.I. et al. (2021) ‘Ambient air pollution and the risk of ischaemic and haemorrhagic stroke’, The Lancet Planetary Health, 5(8). Available at: https://doi.org/10.1016/S2542-5196(21)00145-5.
Published
2024-09-29
How to Cite
SURYANTARINI, Ni Wayan Puspa Wijaya.
DETEKSI DINI ATRIAL FIBRILASI UNTUK MENURUNKAN RISIKO STROKE.
Mandala Of Health, [S.l.], v. 17, n. 2, p. 211-222, sep. 2024.
ISSN 2615-6954.
Available at: <https://jos.unsoed.ac.id/index.php/mandala/article/view/12529>. Date accessed: 05 apr. 2025.
doi: https://doi.org/10.20884/1.mandala.2024.17.2.12529.
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Articles
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