Treatment of AF based on risk stratification

ACC

ASA 325 or no therapy- lone AF, age <60
ASA 325-- Age <> 60, no risk factors;

Anticoagulation
1. Age> 60, coexistant DM or CAD (optional addition of ASA)
2. Age >75-- especially women
3. Heart failure
4. LVEF<.35
5. thyrotoxicosis
6. HTN
7. RHD
8. Prosthetic heart valves
9. Prior thromboembolism
10 Persistent atrial thrombus on TEE

Intensity for anticoagulation:
Numbers 1-6 keep INR 2-3
Numbers 7-10 keep INR 2.5-3.5