title: [Important changes in the Dutch College of General Practitioners (NHG) practice guideline 'Atrial fibrillation': revised practice guideline issued].
abstract: A small number of points in the NHG practice guideline 'Atrial fibrillation' have been reviewed; this has important consequences for general practice. The risk of ischaemic CVA in patients with atrial fibrillation is determined using a new risk score (CHA2DS2-VASc). The target value of the resting ventricular frequency has been increased from a maximum of 90 to a maximum of 110 beats per minute. Oral anticoagulants are indicated in almost all patients aged 65 years and older with atrial fibrillation; the only group in whom antithrombotic medication is not indicated is men under the age of 75 with no cardiovascular comorbidity. Acetylsalicylic acid for the prevention of thrombo-embolism is only indicated if oral anticoagulants are contra-indicated. The new oral anticoagulants (NOACs) have very limited use in the prevention of a thrombo-embolism in general practice.
authors: *Namens de NHG-werkgroep Atriumfibrilleren, waarvan de leden aan het eind van dit artikel worden vermeld.
authors: Maureen
authors: M
authors: van den Donk
authors: Wim
authors: W
authors: Opstelten
mesh_terms: D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D015897:Comorbidity; D058006:General Practice / Q000592:standards*; D006801:Humans; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D012955:Societies, Medical; D020521:Stroke / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D001241:Aspirin