Kakar et al Figure 1 Practical guidelines for antithrombotic therapy in non-valvular atrial ﬁbrillation. Assess risk, and reassess regularly. Note: Risk factors are not mutually exclusive, and are additive to each other in producing a composite risk. An echocardiogram not needed for routine risk assessment but reﬁnes clinical risk stratiﬁcation in case of moderate or severe left ventricular dysfunction and valve disease. †Owing to lack of sufﬁcient clear cut evidence, treatment may be decided on an individual basis, and the physician must balance the risks and beneﬁts of warfarin versus aspirin; as stroke risk factors are cumulative, warfarin may (for example) be used in the presence of 2 or more risk factors. Referral and echocardiography may help in cases of uncertainty. *Since the incidence of stroke and thromboem- bolic events in patients with thyrotoxicosis appears similar to other aetiologies of AF, antithrombotic therapies should be chosen based on the presence of validated stroke risk factors. Abbreviations: INR, international normalized ratio; CVA, cerebrovascular accident;TIA, transient ischemic attack. therapy targeting incidence of AF and improved and newer anticoagulation regimes. Disclosures GL has received funding for research, educational symposia, consultancy, and lecturing from different manufacturers of drugs used for the treatment of atrial ﬁbrillation and throm- bosis. He is Clinical Adviser to the Guideline Development Group writing the United Kingdom National Institute of Clinical Excellence (NICE) Guidelines on atrial ﬁbrillation management (www.nice.org.uk). References Alboni P, Botto GL, Baldi NL, et al. 2004. Outpatient treatment of recent- onset atrial ﬁbrillation with the “pill-in-the-pocket” approach. N Eng J Med, 351:2384-91. Almassi GH, Schowalter T, Nicolosi AC, et al. 1997. Atrial ﬁbrillation after cardiac surgery: a major morbid event? Ann Surg, 226:501–11. Antonielli E, Pizzuti A, Palinkas A, et al. Clinical value of left atrial appendage ﬂow for prediction of long-term sinus rhythm maintenance in patients with nonvalvular atrial ﬁbrillation. J Am Coll Cardiol, 39:1443–9. Aronow WS, Ahn C, Kronzon I, et al. 1998. Risk factors for new thromboem- bolic stroke in patients ≥62 years of age with chronic atrial ﬁbrillation. Am J Cardiol, 82:119–21. Benavente O, Hart R, Koudstaal P, et al. 2003. Oral anticoagulants for prevent- ing stroke in patients with non-valvular atrial ﬁbrillation and no previous history of stroke or transient ischemic attacks. The Cochrane Library. 114 Vascular Health and Risk Management 2007:3(1)