Anti-arrythmia

 Patient with AF should be assessed for risk of stroke and the need for thromboprophylaxis
o Analysis of risk of bleeding vs benefit of prevention of stroke
o Use CHA2DS2-VASc  risk of stroke
 Risks include: prior ischemic stroke, transient ischemic attacks,
or thromboembolic events, heart failure, left ventricular systolic
dysfunction, vascular disease, diabetes, hypertension, females,
and patients over 65 years.
 Low risk do not require antithrombotic ; high risk
o HAS-BLED tool for bleeding risk prior to and during anticoagulation
o Oral anticoagulant offered to those who
  confirmed diagnosis of atrial fibrillation
  had, or are at high risk of recurrence of atrial fibrillation
 structural heart disease, prolonged history of atrial
fibrillation (more than 12 months), a history of failed
attempts at cardioversion, and patients whom the risk of
stroke outweighs the risk of bleeding
 Vit K antagonist ( warfarin)
 Apixaban, dabigatran or rivaroxaban.

ACS
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