[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.