Embolic, ischemic stroke can occur with any form of atrial fibrillation including paroxysmal, persistent or permanent. Absent contraindication, oral anticoagulation therapy is required in patients with atrial fibrillation who have a CHAD2DS2-VASc of 2 or greater. There is unequivocal, abundant evidence in the medical literature to support the benefit of anticoagulation therapy for patients with atrial fibrillation who fall into this category of risk. Not only is the risk of stroke decreased with anti-coagulant therapy, but the severity of the stroke is decreased, also. Several trials have indicated that the overall risk of adjusted dose warfarin reduces the risk of stroke by two thirds compared to patients who take no anti-coagulant therapy.
The risk of anticoagulant therapy must weighed against the risk of bleeding from warfarin or other anticoagulant drugs.
Ischemic stroke from atrial fibrillation medical expert witness specialties include cardiology, vascular neurology, neurology, vascular surgery, and hematology.