Atrial fibrillation (AF) now a days has become a common and serious condition affecting almost 1-2% of the total population of age group 65 years and above. Increase in the aging population leads to increase in the prevalence further leads to increase rick of premature death. Among the different types of strokes atrial fibrillation has got the higher chances of strokes i.e. around 5 times more. The only way to inhibit stroke is managing atrial fibrillation. There are many deaths registered due to lack of proper treatment and inadequate dosage or use of oral anticoagulants (OACs). Thus, there is an urgent need for proper diagnose and better medication and adherence to oral anticoagulation drugs.
A major problem of AF is the existence of stroke. Due to asymmetrical heartbeats, the blood sometimes is not pump out of the heart correctly and there might be a clot formation in any of the heart chambers. A small piece of this blood clot may break down and move to vessels leading to the upper and lower body. Thus this clot blocks the blood and oxygen flow to the brain. Eighty percent of strokes are majorly an ischemic stroke and it can be primary reduced the rick to around 50 percent by taking blood thinner.
Atrial fibrillation (AF) can be diagnosed generally by execution of electrocardiogram (EKG), there is a test that also registers the heart’s electrical activity. Atrial fibrillation sometimes may not be continual, so a typical EKG may be preferred and it is difficult to detect abnormalities in an official meetings. For this there is a portable electrocardiogram, known as Holter monitor, which can be used at home throughout day and night. There is a provenience of viewing the data on monitors that can be used for longer than 24 hours, if required.
As discussed earlier, there should be a proper treatment for prevention and cure of stroke by taking the preliminary drugs like oral anticoagulants (OACs). These are the drugs which are sometimes called as blood thinners. The mechanism of action of anticoagulants are interruption of blood clotting process, which is also termed as coagulation cascade.
Noval Oral Anticoagulants for Atrial fibrillation (AF) are of two types, they are oral direct thrombin inhibitors and oral direct factor Xa inhibitors. The drugs which help in blocking the formation of clot as a single step are Vit K dependent coagulation factor like factors II, VII, IX and X.
- Vitamin K antagonist (VKAs) mechanism is promoted by interrupting the production of clotting proteins in the blood. This is the drugs which is been in use since many years and is very effective. Warfarin also known as Coumadin which is the Vit K antagonist.
- Thrombin is used since many years as that of Warfarin and it is the major and special enzyme used or involved in the formation of clot. As said earlier by preventing the thrombin, the process of clot formation hinders, thus it take time to form a clot.
- Factor Xa is also one of the enzyme which is used in the process of clot formation. This has a similar mechanism of action as that of Thrombin.
There are some patients who go for Electrical cardioversion where an electric shock is given from a device called cardioverter and the shock is delivered by the paddles attached to the chest to set the heart rhythm. This scenario is majorly suited when the atrial fibrillation interrupts with the blood flow carrying insufficient oxygen to the vital organs of the body. There is also a process known as Transesophageal Echocardiography (TEE) which adjourns cardioversion to blood thinner. This delays the process to clot for two to three weeks. There is also a process called radiofrequency ablation which cures the Atrial Fibrillation to certain limit because this is still in evolving process and have many serious complication.
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Some of the major market players in Stroke Prevention in Atrial Fibrillation (SPAF) Treatment Market globally include Boehringer Ingelheim, Bayer, Johnson & Johnson, Bristol-Myers Squibb, Pfizer, Daiichi-Sankyo, Gilead.
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