Atrial Fibrillation

Oct 1, 2017 Issue
Assessing Bleeding Risk in Patients Taking Anticoagulants [Point-of-Care Guides]

Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed and validated t...

Sep 1, 2017 Issue
Newly Detected Atrial Fibrillation: AAFP Updates Guideline on Pharmacologic Management [Practice Guidelines]

The American Academy of Family Physicians, with the American College of Physicians, has updated its 2003 guideline to provide guidance on atrial fibrillation treatment via medication in the primary care setting. The guideline focuses on adults with nonvalvular atrial fibrillation as diagnosed by ele...

Sep 1, 2017 Issue
Differences Between the AAFP Atrial Fibrillation Guideline and the AHA/ACC/HRS Guideline [Editorials]

The AAFP updated its guideline on pharmacologic management of newly detected atrial fibrillation, which differs in part from the AHA/ACC/HRS guideline. It specifically highlights two questions commonly faced by family physicians, and is based on updated data from the Agency for Healthcare Research and Quality.

Oct 1, 2016 Issue
Rivaroxaban vs. Warfarin for Anticoagulation in Patients with Atrial Fibrillation Undergoing Ablation and Cardioversion [Medicine by the Numbers]

Studies showed that 433 patients needed to be treated with rivaroxaban to prevent one stroke and 629 patients needed to be treated with rivaroxaban to prevent one thromboembolic event. Read more.

Sep 15, 2016 Issue
Diagnosis and Treatment of Atrial Fibrillation [Article]

Although electrocardiography is required in the diagnosis of atrial fibrillation, additional testing may be needed depending on the type of arrhythmia. Treatment options aimed at reducing stroke risk include anticoagulation, cardioversion, ablative and catheter-based procedures, and surgery. Essential therapy still carries risks for patients, and shared decision making is emphasized.

Sep 1, 2015 Issue
Bridging Anticoagulation in Patients with Atrial Fibrillation Associated with More Cardiovascular Events and Bleeding [POEMs]

This study provides more evidence that bridging in patients with nonvalvular atrial fibrillation does not improve outcomes, and is actually associated with a higher risk of bleeding complications and cardiovascular events.

May 1, 2015 Issue
Increased GI Bleeding After Switch from Warfarin to Dabigatran [POEMs]

The risk of bleeding increases (though remains small) when patients with atrial fibrillation are switched from warfarin to dabigatran to prevent stroke or transient ischemic attack. This study, conducted almost exclusively in male veterans, found an increase in gastrointestinal (GI) bleeding, but not in intracranial bleeds.

Jul 15, 2014 Issue
New Anticoagulants vs. Warfarin in Atrial Fibrillation: No Clear Winner [POEMs]

In this meta-analysis, newer anticoagulants appear to be slightly more effective than warfarin in the short term (two years) in preventing strokes of all kinds in patients with atrial fibrillation. However, they are no more effective than warfarin in preventing ischemic strokes, and they cause more ...

May 15, 2014 Issue
Fewer Major Bleeds with Edoxaban Than with Warfarin, but Treatment Benefit Unclear [POEMs]

Edoxaban provides similar effectiveness and a somewhat lower rate of major gastrointestinal and intracranial bleeding than warfarin. It is worth reading the supplemental appendices to this report for a look at the subgroups. For almost all subgroups, low-dose edoxaban caused less major bleeding than...

Apr 15, 2014 Issue
Apixaban (Eliquis) for Stroke Prevention in Atrial Fibrillation [STEPS]

Apixaban is at least as effective as aspirin or warfarin for preventing strokes in high-risk patients with nonvalvular atrial fibrillation, especially those who cannot or will not take warfarin. It is slightly less likely to cause major bleeding and may have better compliance because it does not req...

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