New oral anticoagulants (NOACs) have emerged as an alternative for vitamin K antagonists (VKAs) for thrombo-embolic prevention in patients with non-valvular atrial fibrillation (AF). Although very promising in many regards, the proper use of NOACs will require new approaches in many daily aspects.
Whereas the 2010 ESC Guidelines discuss the indications for anticoagulation in general, they guide less on how to deal with NOAC in specific clinical situations. The European Heart Rhythm Association (EHRA) set out to coordinate a unified way of informing physicians on the practical use of the different NOACs, in a text that supplements the AF Guidelines as a guidance tool for safe, effective use of NOAC when prescribed.