The appeal of the newer medications is that they don’t have dosage adjustments and there are no routine measurements of how well they are working. Usually people on warfarin need to have their INR (international normalized ratio, a measure of coagulation) measured on a regular basis, and the dose may need to be adjusted. Although warfarin is a very useful drug, it can be difficult to manage because it interacts with foods and other medicines that can alter its effectiveness. The first and for many years the only one that was used was warfarin ( Coumadin). That is why most people with a-fib, or atrial fibrillation, are prescribed a medication to prevent clotting. The speed of receiving care, including anti-clotting medication, can also have an impact on stroke damage. The exact size of the clot and the location where it lodges may determine how much damage is caused. If such a clot is then pumped out into circulation, it can lodge in the brain, causing a stroke. These rapid and weak contractions of the upper chambers of the heart can allow some of the blood that would normally have been pumped away to hang around in the heart, possibly long enough to form a clot. When that rhythm falters, as it does in the condition termed atrial fibrillation, blood is still pumped but less effectively. The human heart pushes blood out through the body to all the organs by beating rhythmically.
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