The quest to prevent stroke in atrial fibrillation: Fighting the fluttering heart in Singapore

There has been resurgence in the attention placed on pharmacotherapy in atrial fibrillation (AF) recently as specialists in international conferences discuss the utility of novel anticoagulants with caution owing to limited knowledge of the side effect profile in this nascent stage. AF is a well-known risk factor for stroke and has been for more than 20 years, since warfarin was demonstrated to reduce the risk of stroke, with aspirin doing so to a lesser degree.1 Today, there is international variation in the use of warfarin to prevent stroke despite well-established data.2 Singapore finds itself in a peculiar geographical and clinical position.