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)
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