Thromboembolism associated with atrial fibrillation as a cause of limb and organ ischemia

Abstract

Atrial fibrillation (AF) is associated with a high risk of thromboembolic episodes. Stroke is the most common embolic complication of AF. Consequently, the majority of the conclusions regarding the association between AF and embolism are based on clinical studies of patients with ischemic stroke. The AF-related thromboembolism of limbs and visceral arteries is rarely recognized, and there is little data on this matter. For this reason it is often a neglected issue. Nevertheless, AF is diagnosed in 60-95% of patients operated on due to acute limb ischemia, 31% of patients with splenic artery embolization, 55% with acute renal ischemia and 47% with mesenteric ischemia. AF should be considered as a leading cause of peripheral embolism. Extracerebral AF-related thromboembolic events are associated with serious clinical consequences including a high mortality rate. This paper reviews the current evidence regarding AF as a cause of visceral and limb ischemia.