How is anticoagulation administered in patients with atrial fibrillation (Afib) (AF)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Anticoagulation is indicated as follows:

  • Patients with newly diagnosed AF and those awaiting electrical cardioversion can be started on intravenous (IV) heparin or low-molecular-weight heparin (LMWH) (1 mg/kg twice daily)

  • Concomitantly, patients can be started on warfarin in an inpatient setting while awaiting a therapeutic international normalized ratio (INR) value of 2-3

  • Newer oral anticoagulants present an alternative to warfarin in patients with nonvalvular AF; their onset of action is almost immediate and eliminates the need for bridging with heparin/LMWH.

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