AF
1
2
3
4
5
   • 
• 
• 
• 
• 
Latest AF Trials - H2/2019
ENTRUST-AF
In AF w/PCI, the edoxaban-based regimen was non-inferior for bleeding compared with the VKA-based regimen, without significant differences in ischaemic events.
AFIRE
In AF with stable CAD, Rivaroxaban monotherapy was non-inferior to Rivaroxaban + Antiplatelet Agent with less bleeding.
2019 ACC/AHA/HRS AF Focused Update
NOAC-eligible patients = NON-MARM AF.
MARM = Mechanical valve and Rheumatic Mitral Stenosis
2019 ACC/AHA/HRS AF Focused Update
Circulation 2018.
Reasonable to omit OAC in CHA2DS2-VASc score of 0 in men and 1 in women.
CHA2DS2-VASc score is a strong predictor of thromboembolic events in cardioversion of acute AF performed without anticoagulation.
Am J Cardiol 2016.
In AF/AFL of 48 hrs or unknown duration undergoing cardioversion, anticoagulation is recommended regardless of CHA2DS2-VASc score.
In AF/AFL of <48 hrs with CHA2DS2-VASc>2 in men and >3 in women undergoing cardioversion, anticoagulation is reasonable.
In AF/AFL of <48 hrs with CHA2DS2-VASc=0 in men and =1 in women undergoing cardioversion, anticoagulation vs. no anticoagulation may be considered.
From Fin-CV registry, delay to cardioversion of 12 hours from symptom onset was associated with a greater risk of thromboembodivc complications compared to cardioversion of < 12 hours (1.1% versus 0.3%).
JAMA 2014.
Risk Factors Modification
A game changer for AF management
REVERSE-AF. Europace 2018.
In AF with BMI≥27, weight loss and risk factors modification is recommended.
Risk factors = sleep apnea, hypertension, hyperlipidemia, glucose intolerance, and alcohol and tobacco use.