Primary care management of patients with non-valvular atrial fibrillation who are uncontrolled on warfarin

Development Group: Fay, Assomull, Derry & Price
This management algorithm was developed by a multidisciplinary expert panel: Fay M et al with the support of a grant from Bayer.


Patients with atrial fibrillation (AF) have a five-fold increased risk of stroke. Those determined to be at risk of stroke, such as those scoring two or over on the CHA2DS2VASc score, are generally prescribed anticoagulants as a preventative measure against stroke. While warfarin is the staple treatment, novel oral anticoagulants (NOACs) are an alternative therapy when warfarin has proven ineffective or is contraindicated.

This Guidelines algorithm covers how to respond to poor anticoagulation control in patients with non‑valvular AF receiving warfarin, when to refer to specialist care, and when to prescribe NOACs.


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