The Medical Letter on Drugs and Therapeutics
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1446
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Treatment of Atrial Fibrillation

The treatment of atrial fibrillation includes anticoagulation, rate control, and rhythm control. New US guidelines for the management of atrial fibrillation have recently been published.1

ANTICOAGULATION

Atrial fibrillation increases the risk of thromboembolic stroke. Anticoagulant therapy reduces this risk, but it can cause intracranial and other serious bleeding. The risk of bleeding must be weighed against the benefit of thromboembolic risk reduction.

A new scoring system, the CHA2DS2-VASc score, has been designed to aid in this assessment for patients with nonvalvular atrial fibrillation. An algorithm from the recent US guidelines recommends oral anticoagulant treatment for patients who have a CHA2DS2-VASc score ≥2. For patients with a CHA2DS2-VASc score of 0, who have a very low risk of thromboemboli, ... more      

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