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An Integrated Approach to the Management of a Multimorbid Patient with Atrial Fibrillation from the Standpoint of Modern Guidelines: Rivaroxaban is in Focus

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Atrial fibrillation (AF) is a complex pathology that requires an integrated approach in both diagnosis and treatment, including optimal prevention of thrombosis, control of clinical symptoms, and identification and treatment of cardiovascular risk factors and comorbidities. The article analyzes some of the new positions of the recommendations of the European Society of Cardiology on atrial fibrillation, presented in 2020. Effective diagnostic and therapeutic approaches are discussed in the management of patients with AF in conditions of multimorbidity. The basic principles of the CC to ABC concept, introduced with the aim of improving a structured approach to the treatment of patients with AF, and the 4S-AF regimen necessary for decision on the use of oral anticoagulants, choosing a method of control of the rhythm and / or its frequency, choosing between ablation, cardioversion and antiarrhythmic drugs, as well as to determine the mode of treatment of major cardiovascular diseases. To improve the prognosis and achieve the best results in these patients, the most important is to reduce the risk of stroke, control cardiovascular risks and comorbidities, and ensure high adherence to the therapy within the framework of the concept of comprehensive patient protection. Rivaroxaban is considered by the authors of the article as one of the drugs that provides comprehensive anticoagulant protection of patients with AF. The efficacy profile of rivaroxaban in the prevention of acute cerebrovascular accident and high safety rates were confirmed in a population of multimorbid AF patients of different ages and the highest risk of stroke and / or bleeding.

About the Authors

V. N. Larina
Pirogov National Research Medical University
Russian Federation

Vera N. Larina - SPIN 3674-9620


O. Sh. Oynotkinova
Pirogov National Research Medical University; Research Institute of Healthcare Organization and Medical Management; Moscow State University named after M.V. Lomonosov
Russian Federation

Olga Sh. Oynotkinova - eLibrarySPIN 7783-6965

A. P. Majorova
Pirogov National Research Medical University
Russian Federation

Anna P Majorova - SPIN 3453-0585


G. A. Egiazarian
Pirogov National Research Medical University
Russian Federation

Gamlet A. Egiazarian - SPIN 2688-3947


T. Yu. Demidova
Pirogov National Research Medical University
Russian Federation

Tatiana Yu. Demidova - SPIN 9600-9796



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For citation:

Larina V.N., Oynotkinova O.S., Majorova A.P., Egiazarian G.A., Demidova T.Yu. An Integrated Approach to the Management of a Multimorbid Patient with Atrial Fibrillation from the Standpoint of Modern Guidelines: Rivaroxaban is in Focus. Rational Pharmacotherapy in Cardiology. 2021;17(3):484-491. (In Russ.)

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)