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BioMed Research International
Volume 2015, Article ID 424031, 8 pages
http://dx.doi.org/10.1155/2015/424031
Review Article

Novel Anticoagulants in Atrial Fibrillation: Monitoring, Reversal and Perioperative Management

1Division of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ, USA
2Damascus University Faculty of Medicine, Damascus, Syria
3Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Phoenix, AZ 85054, USA

Received 18 December 2014; Accepted 25 January 2015

Academic Editor: Michele Miragoli

Copyright © 2015 Fadi Shamoun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Atrial fibrillation continues to be a significant source of morbidity and mortality worldwide. Effective anticoagulation remains the cornerstone of outpatient and inpatient treatment. The use of the new generation of anticoagulants (NOACs) continues to grow. Recently published data indicate their cost-effectiveness and overall safety in stroke prevention; compared to vitamin K antagonists, they can be prescribed in fixed doses for long-term therapy without the need for coagulation monitoring. Both United States and European Guidelines recommend NOACs for stroke prevention in patients with atrial fibrillation. This review discusses each of the NOACs, along with their efficacy and safety data. It explores the most recent guidelines regarding their perioperative use in atrial fibrillation patients. It also discusses bleeding complications, perioperative management, and reversal agents.