What are the ESC recommendations for antithrombotic therapy in patients with holiday heart syndrome (HHS)?

Updated: May 30, 2018
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jose M Dizon, MD  more...
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The ESC offers varying recommendations for patients with AF based on CHA2DS2-VASc scores, as follows [31] :

  • CHA 2DS 2-VASc score = 0: No antithrombotic therapy
  • CHA 2DS 2-VASc score = 1: Oral anticoagulants
  • CHA 2DS 2-VASc score ≥2: Oral anticoagulants

The shift from the CHADS2 score to the CHA2DS2-VASc score has not been without controversy. The number of patients eligible for oral anticoagulant therapy in the United States is estimated to increase by nearly 1 million, raising concerns about the associated increase in bleeding complications. An analysis by O’Brien and colleagues concluded that using the 2014 AHA/ACC/HRS recommendations to guide the management of AF would result in 98.5% of patients 65 years of age and older and 97.7% of women with AF receiving a definitive recommendation for oral anticoagulant therapy. [40]

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