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{{familytree | | | D01 | | | | | | | | | | | | | |D01=Anticoagulation as needed based on the risk of stroke <br> Click [[Atrial fibrillation resident survival guide#Risk Factors for Stroke and Recommended Antithrombotic Therapy|here]] for the risk of stroke and anticoagulation therapy
{{familytree | | | D01 | | | | | | | | | | | | | |D01=Anticoagulation as needed based on the risk of stroke <br> Click [[Atrial fibrillation resident survival guide#Risk Factors for Stroke and Recommended Antithrombotic Therapy|here]] for the risk of stroke and anticoagulation therapy
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Recommended in all cases except lone AF (I A) <br> Measure INR weekly initially, then monthly when stable <br> Reassess need for anticoagulation at periodic intervals }}
Recommended in all cases except lone AF (I A) <br> Measure INR weekly initially, then monthly when stable (I A) <br> Reassess need for anticoagulation at periodic intervals (IIa C) }}
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* Dabigatran may be used as an alternative to warfarin in those wdo don't have:
* Dabigatran may be used as an alternative to warfarin in those wdo don't have: (I B)
:* Prosthetic heart valve
:* Prosthetic heart valve
:* Hemodynamically significant valve disease
:* Hemodynamically significant valve disease
:* Severe renal failure (creatinine clearance <15 mL/min) or
:* Severe renal failure (creatinine clearance <15 mL/min) or
:* Advanced liver disease (impaired baseline clotting function).
:* Advanced liver disease (impaired baseline clotting function).
* If patient on anticoagulants with AF sustains stroke or systemic embolism, target INR may be raised to 3.0 - 3.5 (IIb C).
* Anticoagulation therapy can be interrupted for upto 1 week, if patients needs a procedure that carries a risk of bleeding. For periods > 1 week unfractionated or low molecular weight heparin may be given IV.

Revision as of 17:01, 4 March 2014

 
 
 
 
 
 
 
Newly discovered AF
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{-.}}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Paroxysmal
 
 
 
 
 
 
 
Persistent
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Look for the presence of one of these severe symptoms
Hypotension
Heart failure
Angina pectoris

Severe symptoms absent:
No therapy needed


Severe symptoms present:

Attempt direct-current cardioversion
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Anticoagulation as needed based on the risk of stroke
Click here for the risk of stroke and anticoagulation therapy
Recommended in all cases except lone AF (I A)
Measure INR weekly initially, then monthly when stable (I A)
Reassess need for anticoagulation at periodic intervals (IIa C)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • Dabigatran may be used as an alternative to warfarin in those wdo don't have: (I B)
  • Prosthetic heart valve
  • Hemodynamically significant valve disease
  • Severe renal failure (creatinine clearance <15 mL/min) or
  • Advanced liver disease (impaired baseline clotting function).
  • If patient on anticoagulants with AF sustains stroke or systemic embolism, target INR may be raised to 3.0 - 3.5 (IIb C).
  • Anticoagulation therapy can be interrupted for upto 1 week, if patients needs a procedure that carries a risk of bleeding. For periods > 1 week unfractionated or low molecular weight heparin may be given IV.