Why the study?
Oral anticoagulation management can be challenging in special clinical situations, such as complex cases of nonvalvular atrial fibrillation.
This Delphi consensus provides expert recommendations for managing oral anticoagulation in complex clinical scenarios, such as post-PCI, catheter ablation, and post-intracranial hemorrhage.
Supports periprocedural anticoagulation decisions; extends prior guidelines via expert consensus on complex scenarios.
Background: Management of oral anticoagulation (OAC) can be challenging, such as in complex cases of nonvalvular atrial fibrillation (NVAF).Materials & methods: A Delphi study comprising two rounds was used for gathering expert opinion through an online questionnaire (83 items grouped in 8 dimensions) on OAC management in specific clinical settings.Results: Consensus was reached for 79 items (95%) in round 1. Experts recommended direct-acting oral anticoagulants (DOACs) for pericardioversion, uninterrupted OAC for catheter ablation, and dual therapy with a DOAC and clopidogrel after percutaneous coronary intervention. They also recommended restarting OAC with a DOAC after an intracranial haemorrhage.Conclusion: The expert-based recommendations obtained may contribute to standardizing and guiding the management of OAC in complex clinical situations in cardiology.
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Gómez‐Doblas et al. (2024) studied nonvalvular atrial fibrillation (NVAF). Oral anticoagulation (OAC) management was evaluated on Consensus on OAC management in specific clinical settings. A Delphi consensus reached agreement on 95% of items, recommending DOACs for pericardioversion, uninterrupted OAC for catheter ablation, and DOAC plus clopidogrel post-PCI.
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