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Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary.

Publication ,  Journal Article
Heidbuchel, H; Verhamme, P; Alings, M; Antz, M; Diener, H-C; Hacke, W; Oldgren, J; Sinnaeve, P; Camm, AJ; Kirchhof, P; ESC Scientific Document Group,
Published in: Eur Heart J
July 14, 2017

In 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094-2106). The document received widespread interest, not only from cardiologists but also from neurologists, geriatricians, and general practitioners, as became evident from the distribution of >350 000 copies of its pocket version (the EHRA Key Message Booklet) world-wide. Since 2013, numerous new studies have appeared on different aspects of NOAC therapy in AF patients. Therefore, EHRA updated the Practical Guide, including new information but also providing balanced guiding in the many areas where prospective data are still lacking. The outline of the original guide that addressed 15 clinical scenarios has been preserved, but all chapters have been rewritten. Main changes in the Update comprise a discussion on the definition of 'non-valvular AF' and eligibility for NOAC therapy, inclusion of finalized information on the recently approved edoxaban, tailored dosing information dependent on concomitant drugs, and/or clinical characteristics, an expanded chapter on neurologic scenarios (ischaemic stroke or intracranial haemorrhage under NOAC), an updated anticoagulation card and more specifics on start-up and follow-up issues. There are also many new flow charts, like on appropriate switching between anticoagulants (VKA to NOAC or vice versa), default scenarios for acute management of coronary interventions, step-down schemes for long-term combined antiplatelet-anticoagulant management in coronary heart disease, management of bleeding, and cardioversion under NOAC therapy. The Updated Guide is available in full in EP Europace (Heidbuchel H, Verhamme P, Alings M, Antz M, Diener HC, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, Advisors. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507), while additional resources can be found at the related ESC/EHRA website (www.NOACforAF.eu).

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Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 14, 2017

Volume

38

Issue

27

Start / End Page

2137 / 2149

Location

England

Related Subject Headings

  • Thromboembolism
  • Practice Guidelines as Topic
  • Platelet Aggregation Inhibitors
  • Nervous System Diseases
  • Intraoperative Care
  • Humans
  • Electric Countershock
  • Elective Surgical Procedures
  • Coronary Artery Disease
  • Contraindications, Drug
 

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Heidbuchel, H., Verhamme, P., Alings, M., Antz, M., Diener, H.-C., Hacke, W., … ESC Scientific Document Group, . (2017). Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary. Eur Heart J, 38(27), 2137–2149. https://doi.org/10.1093/eurheartj/ehw058
Heidbuchel, Hein, Peter Verhamme, Marco Alings, Matthias Antz, Hans-Christoph Diener, Werner Hacke, Jonas Oldgren, et al. “Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary.Eur Heart J 38, no. 27 (July 14, 2017): 2137–49. https://doi.org/10.1093/eurheartj/ehw058.
Heidbuchel, Hein, et al. “Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary.Eur Heart J, vol. 38, no. 27, July 2017, pp. 2137–49. Pubmed, doi:10.1093/eurheartj/ehw058.
Heidbuchel H, Verhamme P, Alings M, Antz M, Diener H-C, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, ESC Scientific Document Group. Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary. Eur Heart J. 2017 Jul 14;38(27):2137–2149.
Journal cover image

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 14, 2017

Volume

38

Issue

27

Start / End Page

2137 / 2149

Location

England

Related Subject Headings

  • Thromboembolism
  • Practice Guidelines as Topic
  • Platelet Aggregation Inhibitors
  • Nervous System Diseases
  • Intraoperative Care
  • Humans
  • Electric Countershock
  • Elective Surgical Procedures
  • Coronary Artery Disease
  • Contraindications, Drug