A review of contemporary data supports further investigation of a targeted 'pill-in-the-pocket' anticoagulation strategy for atrial fibrillation, which will be evaluated in the REACT-AF trial.
Does targeted "pill in the pocket" anticoagulation prevent stroke in patients with atrial fibrillation compared to uninterrupted anticoagulation?
This review outlines the rationale for a targeted "pill in the pocket" anticoagulation strategy for atrial fibrillation and introduces the upcoming REACT-AF trial to evaluate this approach.
Uninterrupted anticoagulation for atrial fibrillation (AF), regardless of AF burden, is deeply rooted in practice since the early anticoagulation trials. However, uninterrupted anticoagulation is not without risks, and may not be beneficial for allcomers with a history of AF. Indeed, contemporary data that support a critical duration threshold of AF that benefits from anticoagulation, and a temporal association between stroke and multihour AF episodes, compel the study of a more targeted approach to AF anticoagulation. In this review, we discuss data that support further investigation of "pill in the pocket" anticoagulation for AF, and introduce the pivotal Rhythm Evaluation for Anticoagulation Therapy for Atrial Fibrillation (REACT-AF) trial that will robustly evaluate this strategy.
Peigh et al. (Fri,) conducted a review in Atrial fibrillation. Pill-in-the-pocket anticoagulation vs. Uninterrupted anticoagulation was evaluated. A review of contemporary data supports further investigation of a targeted 'pill-in-the-pocket' anticoagulation strategy for atrial fibrillation, which will be evaluated in the REACT-AF trial.