Disclaimer
This is a compilation of anticoagulation management resources in nonvalvular atrial fibrillation (NVAF) published between January 2014 and April 2021. It includes NVAF management guidelines, clinical pathways and protocols, and guidance and consensus statements on anticoagulation management in special situations, such as during ablation or cardioversion; in patients who are bleeding or require anticoagulation reversal; in patients who are elderly, obese, or have hepatic or renal impairment; in patients switching between anticoagulants; in those with possible drug-drug or drug-food interactions; and in those with concomitant valvular heart disease (direct oral anticoagulants [DOACs] are not indicated for use in patients with mechanical heart valves). Resources to help guide provision of inpatient quality and performance measures and transitions of care and online links to patient education materials are also included. Publications are included in all sections in this compendium to which they are relevant and, therefore, some appear several times throughout. This compendium does not provide a comprehensive list of all anticoagulation clinical pathway documentation related to NVAF, but is based on a literature and Web search that is defined in the Methodology. (The methodology and search strategies are detailed in the Methodology link.) The links provided are made available to assist health care professionals in identifying approaches to anticoagulation management in NVAF patients. Publications that may not describe currently available treatment options and/or anticoagulation reversal agents are included by nature of the search criteria outlined in the Methodology. Bristol Myers Squibb/Pfizer Alliance neither recommends nor endorses any of the websites or articles listed or the information contained therein. All registered names or brands referenced in this document remain the property of their respective owners and are included for identification purposes only. Periodic (quarterly) updates based on the PubMed® and Google® searches outlined in the Methodology are planned; ad hoc updates will be considered as major clinical treatment guidelines, position statements, and consensus statements are published.
Methodology
Searches of PubMed® and Google® were conducted to identify articles published in English between January 2014 and April 2021 using search terms listed below. To supplement the PubMed and Google searches, ad hoc searches of websites of relevant professional organizations, patient advocacy groups, and select US-based metropolitan health care institutions were performed.
PubMed
Title/abstract searches:
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((atrial fibrillation) AND (anticoagulation OR anticoagulant)) AND (pathway OR protocol OR guideline OR guidance OR consensus OR expert OR statement)
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((atrial fibrillation) AND (anticoagulation OR anticoagulant)) AND (transition OR discharge)
PubMed searches were limited to content published during or after 2014 to reflect the most recent publications in the field. Articles relevant to the United States were prioritized and clinical studies and case studies were excluded, except as noted in the Transition of Care section. All results were reviewed for relevance, and additional articles were identified from the reference lists of reviewed publications. Ad hoc PubMed searches were conducted using specific search terms (ie, algorithm, emergency medicine, ablation, cardioversion, reversal, body weight, elderly, hepatic impairment, renal impairment, prosthetics, quality measures, and quality indicators) to help ensure that publications pertaining to these topics were captured. Only publically available online resources for which a paid subscription was not necessary to view content were included. Links to full-text articles are included if no purchase is required; articles for which purchase is required to view the full text are identified.
Searches
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“atrial fibrillation anticoagulation guidelines”
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“atrial fibrillation anticoagulation transition of care”
For Google search results, only the first 5 pages of results, listed by relevance, were reviewed. Health care institutions with publicly available anticoagulation protocols were identified by Pfizer, through the Google search, or through other sources identified in this compendium.
Within each section of this compendium, journal articles are generally listed by subject matter and in reverse chronologic order (newest to oldest) and online publications from institutions or organizations are listed alphabetically.
Because this compendium includes information published between January 2014 and April 2021, all currently available treatment options and/or reversal agents may not be included.
Periodic (quarterly) updates based on the PubMed and Google searches outlined in the Methodology are planned; ad hoc updates will be considered as major clinical treatment guidelines, position statements, and consensus statements become available.