New algorithm for periprocedural anticoagulation management in nonvalvular Afib

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Takeaway 

  • Managing anticoagulation in patients with atrial fibrillation (Afib) undergoing surgical procedures is an ongoing challenge across specialties, and this consensus algorithm offers step-by-step guidance.

Highlights

  • Focused on patients with nonvalvular Afib for whom anticoagulation is a clinical indication and who are having elective surgeries.
  • Summary graphic included in paywalled article.
  • Algorithm addresses key decision points:
  • --Whether to interrupt: Evaluate bleed risk (eg, HAS-BLED), use clinical judgment; if risk low, no need to interrupt. If high, decide when to interrupt.
  • --When to interrupt: Consider anticoagulant, kidney function, internal normalized ratio (INR). INR determines time frame for interruption (eg, at goal INR=might di...