This Harvard Medical School Continuing Education video examines these key questions: Who is an appropriate candidate for anticoagulation in atrial fibrillation (AF)? How is the CHA2DS2-Vasc score used to determine anticoagulation? What are bleeding risks associated with anticoagulation in AF patients?

Dr. William Hucker, MD, PhD, a cardiologist at Massachusetts General Hospital, identifies the prevention of stroke and systemic embolism as vital aspects of AF management and explains the use of the CHA2DS2-Vasc score to determine which patients should be anticoagulated. The use of DOACs in nonvalvular AF is discussed and addressing bleeding risk with patients is reviewed.

00:00 | Introduction
00:41 | Treatment of atrial fibrillation
01:29 | Risk stratification for AF
03:55 | Guidelines for anticoagulation
06:50 | Addressing bleeding risks
08:55 | Periprocedural anticoagulation considerations

This video was peer reviewed by Dr. Jonathan Salik, TMD, MHPEd, Instructor of Medicine, Massachusetts General Hospital; and Dr. Sugantha Sundar, MD, Assistant Professor of Anesthesia, Beth Israel Deaconess Medical Center, to validate the quality and accuracy of the content.

References:
Friberg L, Skeppholm M, Terént A. Benefit of anticoagulation unlikely in patients with atrial fibrillation and a CHA2DS2-VASc score of 1. J Am Coll Cardiol.
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Writing Group Members, January CT, Wann LS, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2019;16(8):e66-e93. doi:10.1016/j.hrthm.2019.01.024
Granger, CB, Patel MR, Mahaffey KW, Garg J, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011.
Connolly SJ, Eikelboom J, Joyner C, Diener H, et al. Apixaban in patients with atrial fibrillation. N Engl J Med. 2011;364:806-817. doi:10.1056/NEJMoa1007432
Douketis JD, Spyropoulos AM, Kaatz S, Becker RC, et al. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med. 2015;373:823-833. doi:10.1056/NEJMoa1501035
Notice: At this time, the content in this video is not accredited.