The ACCF/AHA/HRS just published guidelines on the use of dabigatran in Afib. This was a focused update for the 2006 full guidelines on the management of Afib. They recommend to continue warfarin in patients who are currently on it and well maintained (therapeutic INR). For all other patients, dabigatran can be considered, after consideration of: twice daily dosing, lack of antidote in case of bleeding, creatinine clearance (not to be used if CrCl<15, and reduced dose for crcl 15-30), and cost (ACC update)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.