European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation
Open accessAbstract
New oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with non-valvular atrial fibrillation (AF). Both physicians and patients will have to learn how to use these drugs effectively and safely in clinical practice. Many unresolved questions on how to optimally use these drugs in specific clinical situations remain. The European Heart Rhythm Association set out to coordinate a unified way of informing physicians on the use of the different NOACs. A writing group listed 15 topics of concrete clinical scenarios and formulated as practical answers as possible based on available evidence. The 15 topics are: (1) Practical start-up and follow-up scheme for patients on NOACs; (2) How to measure the anticoagulant effect of NOACs; (3) Drug-drug interactions and pharmacokinetics of NOACs; (4) Switching between anticoagulant regimens; (5) Ensuring compliance of NOAC intake; (6) How to deal with dosing errors; (7) Patients with chronic kidney disease; (8) What to do if there is a (suspected) overdose without bleeding, or a clotting test is indicating a risk of bleeding? (9) Management of bleeding complications; (10) Patients undergoing a planned surgical intervention or ablation; (11) Patients undergoing an urgent surgical intervention; (12) Patients with AF and coronary artery disease; (13) Cardioversion in a NOAC-treated patient; (14) Patients presenting with acute stroke while on NOACs; (15) NOACs vs. VKAs in AF patients with a malignancy. Since new information is becoming available at a rapid pace, an EHRA Web site with the latest updated information accompanies this text (www.NOACforAF.eu).
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Anticoagulation with NOACs is an alternative to warfarin for patients undergoing catheter ablation.
“Anticoagulation with NOACs is an alternative to warfarin.478,[761][762][763][764][765]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [478]
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The Use of Dabigatran Immediately After Atrial Fibrillation Ablation
Winkle, R. A., Mead, R. H., Engel, G., Kong, M. H., & Patrawala, R. A. (2011) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2011.02175.x · Cited by 122 · see citing works
Decrease in the oral bioavailability of dabigatran etexilate after co‐medication with rifampicin
Härtter, S., Koenen‐Bergmann, M., Sharma, A., Nehmiz, G., Lemke, U., Timmer, W., & Reilly, P. A. (2012) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2012.04218.x · Cited by 120 · see citing works
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Safety of percutaneous coronary intervention during uninterrupted oral anticoagulant treatment
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Coadministration of Dabigatran Etexilate and Atorvastatin
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Interpretation of Point-of-care INR Results in Patients Treated with Dabigatran
van Ryn, J., Baruch, L., & Clemens, A. (2012) · The American Journal of Medicine · doi:10.1016/j.amjmed.2011.10.017 · Cited by 83 · see citing works
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Berti, D., Hendriks, J., Brandes, A., Deaton, C., Crijns, H. J. G. M., Camm, A. J., Hindricks, G., Moons, P., & Heidbüchel, H. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht096 · Cited by 78 · see citing works
Self-citationAdherence and dosing frequency of common medications for cardiovascular patients.
Bae, J. P., Dobesh, P. P., Klepser, D. G., et al. (2012) · PubMed · Cited by 76 · see citing works
Safe Use of Hemodialysis for Dabigatran Removal before Cardiac Surgery
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A comparison of bleeding complications post-ablation between warfarin and dabigatran
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Lópes, R. D., Starr, A. Z., Pieper, C. F., Al‐Khatib, S. M., Newby, L. K., Mehta, R. H., de Werf, F. V., Mahaffey, K. W., Armstrong, P. W., Harrington, R. A., et al. (2010) · The American Journal of Medicine · doi:10.1016/j.amjmed.2009.09.015 · Cited by 39 · see citing works
“R” for “Renal” and for “Risk”
Camm, A. J., & Savelieva, I. (2013) · Circulation · doi:10.1161/circulationaha.112.147512 · Cited by 15 · see citing works
Self-citationAbstracts From the Emerging Science Series, June 20, 2012
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Hospital Universitario La Paz, Madrid
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Flagged first, then by citations
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Cited by
Sorted by citations
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Self-citation2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
Self-citationSteffel, J., Collins, R., Antz, M., Cornu, P., Desteghe, L., Haeusler, K. G., Oldgren, J., Reinecke, H., Roldan-Schilling, V., Rowell, N., et al. (2021) · EP Europace · doi:10.1093/europace/euab065 · Cited by 1,132 · see citing works
Self-citationCappato, R., Marchlinski, F. E., Hohnloser, S. H., Naccarelli, G. V., Xiang, J., Wilber, D. J., Ma, C.-S., Hess, S., Wells, D. S., Juang, G., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv177 · Cited by 422 · see citing works
Kirchhof, P., Breithardt, G., Aliot, E., Al Khatib, S., Apostolakis, S., Auricchio, A., Bailleul, C., Bax, J., Benninger, G., Blomstrom-Lundqvist, C., et al. (2013) · Europace · doi:10.1093/europace/eut232 · Cited by 141 · see citing works
Management of acute stroke in patients taking novel oral anticoagulants
Hankey, G. J., Norrving, B., Hacke, W., & Steiner, T. (2014) · International Journal of Stroke · doi:10.1111/ijs.12295 · Cited by 63 · see citing works
Self-citationFaxon, D., Airaksinen, J., Schlitt, A., Marìn, F., Bhatt, D., Lip, G., & Rubboli, A. (2014) · Thrombosis and Haemostasis · doi:10.1160/th14-08-0681 · Cited by 60 · see citing works
- Authors
- Heidbuchel, H., Verhamme, P., Alings, M., Antz, M., Hacke, W., Oldgren, J., Sinnaeve, P., Camm, A. J., & Kirchhof, P.
- Affiliations
- University Hospital Gasthuisberg 1 Department of Cardiovascular Medicine , , , Leuven ,
- Universitair Ziekenhuis Leuven (BE)
- Amphia Ziekenhuis (NL)
- Klinikum Oldenburg (DE)
- Heidelberg University (DE)
- Uppsala University (SE)
- St. George's University (GD)
- University of Münster (DE)
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-05-01
- Volume
- 15
- Issue
- 5
- Pages
- 625-651
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2129241155
- Cited by
- 792
- References
- 102
- Citations by year
- 2026: 2 · 2025: 12 · 2024: 14 · 2023: 7 · 2022: 17 · 2021: 27 · 2020: 28 · 2019: 30 · 2018: 68 · 2017: 70 · 2016: 127 · 2015: 191 · 2014: 147 · 2013: 52
- FWCI
- 117.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- zvestiya of the National Academy of Sciences of Belarus (National Academy of Sciences of Belarus) (submittedVersion, cc-by)
- Funders
- Bristol-Myers Squibb
- Pfizer
- AstraZeneca
- Sanofi
- Boston Scientific Corporation
- European Commission
- Bayer HealthCare
- Deutsche Forschungsgemeinschaft
- Fondation Leducq
- Bundesministerium für Bildung und Forschung
- Daiichi-Sankyo
- Deutsche Gesellschaft für Kardiologie-Herz und Kreislaufforschung.
- Servier
- Menarini Group
- St. Jude Medical
- Merck Sharp and Dohme
- Biosense Webster
- Daiichi Sankyo Europe
- Actelion Pharmaceuticals
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- direct oral anticoagulants, non-valvular atrial fibrillation, stroke prevention, vitamin K antagonists, anticoagulation management, drug-drug interactions, pharmacokinetics, medication adherence, dosing errors, chronic kidney disease, anticoagulant overdose, bleeding complications, cardioversion, acute stroke, coronary artery disease, cancer, surgical treatment, ablation
- MeSH terms
- Administration, Oral, Anticoagulants, Atrial Fibrillation, Cardiology, Europe, Heart Valve Diseases, Thrombosis
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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