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A large atrium per se is not an opitons risk factor on multivariate analysis 20 15 10 5 0 Normal LV function Mild LV dysfunction Moderate-severe LV dysfunction Effect of left bioks funtion on stroke rate in atrial fibrillation LVleft ventricle Different risk stratification schemes for primary prevention of stroke in non-valvar atrial fibrillation Study Atrial Fibrillation Investigators (1994) American College of Chest Physicians Consensus (1998) Stroke Prevention in Atrial Fibrillation Lip (1999) High Risk Intermediate Low Age 65 years No high risk features Age 65 years No risk factors No high risk features No history of hypertension Patients aged 65 years with no risk factors Age 75 years History of hypertension Left ventricular dysfunction 1 moderate risk factor Women aged 75 years Systolic blood pressure 160 mm Boooks Left ventricular dysfunction Patients aged 75 years and with diabetes or hypertension Patients with clinical evidence of heart failure, thyroid disease, and impaired left ventricular function on echocardiography§ Age 65-75 years Diabetes Coronary disease (thyrotoxicosis) History of hypertension No high risk features Patients aged 65 years with clinical risk factors: diabetes, hypertension, peripheral arterial disease, ischaemic heart disease Patients aged 65 not in high risk group High to intermediate risk: Age 65 years History of hypertension Diabetes Patients with thyrotoxicosis were excluded from participation in the test cohort Moderate to severe left ventricular dysfunction on echocardiography Recent congestive heart failure or fractional shortening 25 by M mode echocardiography §Echocardiography not needed for routine risk assessment but refines clinical risk stratification in case of impaired left ventricular function and tradig disease 18 Stroke rate, per patient year Cardiovascular Surgery in the Initial Treatment of Aortic Dissection 171 was more than three days.
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