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KMID : 1011920110120030032
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International Journal of Arrhythmia
2011 Volume.12 No. 3 p.32 ~ p.35
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Bleeding complication during anticoagulation therapy in atrial fibrillation
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Choi Eue-Keun
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Abstract
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Long-term anticoagulation therapy to prevent stroke in patients with atrial fibrillation has resulted in an increase in warfarin-associated bleeding complications, including fatal bleeding events such as intracerebral hemorrhage (ICH). Treatment of bleeding complications varies widely, and optimal therapy is yet to be defined. Here, we report 2 cases of bleeding complications during anticoagulation therapy for atrial fibrillation. In the first patient, ICH developed despite administration of drug doses that were within the conventional anticoagulant therapeutic range. Anticoagulation therapy was terminated, and the bleeding stopped by administration of vitamin K and fresh frozen plasma. However, emergency craniotomy and hemorrhage evacuation were needed to successfully treat the ICH. The second patient developed compartment syndrome in the lower left leg during anticoagulation therapy. After conservative management, warfarin was replaced by aspirin to prevent stroke. However, acute cerebral infarction developed 3 months later. Although there is no consensus on how to best treat warfarin-associated bleeding complications, it is reasonable to approach this problem on a case by case basis, with the help of experts.
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KEYWORD
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anticoagulation, atrial fibrillation, bleeding
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