Anticoagulant Therapy in Acute (Duration Less Than 48 Hours) Atrial Fibrillation

Anticoagulant therapy in acute (duration less than 48 hours) atrial fibrillation. In small-risk and moderate-risk patients, cardioversion of acute atrial fibrillation may be performed without preceding anticoagulant therapy if the duration of the arrhythmia has been less than 12 hours. In other cases, either a direct oral anticoagulant or low molecular weight heparin (LMWH) and warfarin should be started already before cardioversion. After cardioversion, anticoagulant therapy should be continued, taking the risk factors into account, for at least 1 month or permanently (see article text for further details).

Notice that a modified version of the CHA₂DS₂VASC score is applied here, where female sex gives one point only if age is ≥ 75 years, allowing the use of identical cut-off values for both men and women. For more information on the modification, see Indications for and Implementation of Anticoagulant Therapy in Atrial Fibrillation.

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Picture: The Finnish Medical Society Duodecim