Which medication should be administered if a patient experiencing AF is at risk for stroke?

When a patient experiencing atrial fibrillation (AF) is at risk for stroke, the appropriate course of action is to administer anticoagulation medication. This is because AF increases the likelihood of blood clots forming in the atria, particularly in the left atrial appendage. If these clots dislodge, they can travel to the brain and cause a stroke. Anticoagulants help inhibit blood clot formation, thus significantly lowering the risk of stroke in these patients.

It’s crucial to assess the patient's stroke risk using tools like the CHA2DS2-VASc score, which helps determine whether anticoagulation therapy is warranted. Factors such as age, history of heart failure, hypertension, diabetes, and prior stroke or transient ischemic attack all contribute to this risk evaluation. When the score indicates that the patient is at increased risk, anticoagulation therapy—such as with warfarin or novel oral anticoagulants—is recommended to provide protection against stroke.

Other options, while important in managing AF, do not specifically address the concern of stroke prevention. Verapamil is a calcium channel blocker used to control heart rate but does not prevent clot formation. Adenosine is primarily used to terminate reentrant supraventricular tachy