Antithrombotic Management of Atrial Fibrillation

Atrial fibrillation is the most frequently occurring heart arrhythmia and highly prevalent in the elderly population. The most important clinical consequences of atrial fibrillation are congestive heart failure due to a too low or too high ventricular heart rate and thromboembolic complications due to embolization of clots that have formed due to stasis in the nonfunctional atria. To prevent the latter complication, all patients with atrial fibrillation need to be treated with anticoagulants, most often vitamin K antagonists (VKAs). In fact, millions of people worldwide use VKAs for the prevention of thromboembolic complications of atrial fibrillation, and atrial fibrillation is by far the most common indication for the use of VKAs.1 In recent years a steady increase in the knowledge about the efficacy and safety of antithrombotic agents, in particular VKAs, has been accumulated in various patient categories.2 This issue of Seminars in Thrombosis and Hemostasis aims to present the current state of the art in this field.