Electrophysiology
DOACs vs warfarin, bleeding risk, and stroke prevention
Also called DOAC AF, NOAC atrial fibrillation, AF anticoagulation
Sources: updated Oct 3, 2026
Specific, answerable questions in this area — each with its own synthesized evidence and consensus. Open one to see the forest plot, source trials, and how the consensus has changed over time.
Does oral anticoagulation vs placebo improve All-Cause Mortality in Atrial Fibrillation?
Low CertaintySupports benefitoral anticoagulation vs placebo · All-Cause Mortality
Does oral anticoagulants vs placebo improve Intracranial Hemorrhage in Atrial Fibrillation?
Low Certaintyoral anticoagulants vs placebo · Intracranial Hemorrhage
Synthesized from 34 evidence-backed clinical questions on Anticoagulation in AF — 26 supports benefit, 8 no benefit shown.
The placed evidence leans toward benefit
26
Favor benefit
76% of all
8
No benefit shown
24% of all
Low certainty on 100% of questions
Does oral anticoagulation vs placebo improve All-Cause Mortality in Atrial Fibrillation?
Low Certainty+ Favors benefitoral anticoagulation vs placebo · All-Cause Mortality
26 studies (1,394,158 patients) provide low-certainty evidence for benefit of oral anticoagulation for All-Cause Mortality in Atrial Fibrillation.
Does vitamin k antagonists vs placebo improve Major Bleeding in Atrial Fibrillation?
Low Certainty− No benefit shownvitamin k antagonists vs placebo · Major Bleeding
10 studies (1,083,901 patients) provide low-certainty evidence against benefit of vitamin k antagonists for Major Bleeding in Atrial Fibrillation.
The evidence sections above show what the literature supports; this is what the field is still arguing about. Open a debate for the camps, the named voices, and the vote.
CABANA and EARLY-AF
Cardiology Trials Journal Club — Tue, Sep 15, 10:00 AM EDT
AFFIRM and RACE
Cardiology Trials Journal Club — Tue, Sep 8, 10:00 AM EDT
VA Journal Club: Factor XI Inhibitors and Atrial Fibrillation
UCLA #bruinhearts Journal Club Section — Fri, Aug 7, 11:00 AM EDT
Sessions from public journal clubs on Synapse. RSVP to join the live discussion.
A clinical question appears here only when its condition matches this topic, an outcome and a comparator were extracted from the studies, at least two studies and a patient count are on file, and the certainty is low or higher.
Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.
Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.
The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.
“CABANA failed to demonstrate a statistically significant reduction in primary composite cardiovascular outcomes for catheter ablation compared with medical therapy.”
“For older, minimally symptomatic atrial fibrillation patients, rhythm control does not improve survival compared with rate control and requires continued anticoagulation.”
Hamilton General Hospital
h-index 120 · 77k citations
Most-cited researchers publishing on Anticoagulation in AF.
