title: Anticoagulation in atrial fibrillation and chronic heart failure: the risk and drug of choice.
abstract: OBJECTIVE
  This review seeks to provide an evidence-based update on the issue of atrial fibrillation and chronic heart failure with an emphasis on anticoagulation and the expanding use of the novel oral anticoagulants (NOACs).
  
  
  RESULTS
  There is an increasing appreciation of the important reciprocal relationship between atrial fibrillation and heart failure and the negative prognostic impact that each condition has on the other. There are now four NOACs approved for stroke prevention in atrial fibrillation. There are increasing data to support their use in atrial fibrillation with heart failure, including in patients with nonmechanical or rheumatic valvular disease, and to facilitate direct current cardioversion. The choice of NOAC is heavily dependent on individual patient characteristics.
  
  
  CONCLUSIONS
  The use of and indications for NOACs for patients with heart failure and atrial fibrillation are rapidly increasing.
authors.affiliation: aDepartment of Cardiology, Poole Hospital NHS Foundation Trust, Poole bDepartment of Postgraduate Medical Education, Bournemouth University, Bournemouth, UK.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Boos
authors.forename: Louise
authors.initials: L
authors.lastname: Brown
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000145:classification / Q000494:pharmacology; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D001777:Blood Coagulation / Q000187:drug effects*; D019468:Disease Management; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D018579:Patient Selection; D011379:Prognosis; D020379:Risk Adjustment; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants