High Thromboembolic Risk in Atrial Fibrillation

Based on data from clinical studies, there are 3 clinical situations in which patients with atrial fibrillation (AF) must receive anticoagulant therapy regardless of the CHA₂DS₂-VA score:

Valvular AF (Warfarin is always administered):

Mechanical valve
Mitral stenosis (moderate or severe)

Hypertrophic cardiomyopathy (preferably NOAC or Warfarin)
Cardiac amyloidosis (preferably NOAC or Warfarin)

Infographic illustrating atrial fibrillation with high thromboembolic risk in valvular atrial fibrillation, hypertrophic cardiomyopathy, and amyloidosis with recommended anticoagulation using warfarin or NOACs.

Anticoagulant Therapy (Regardless of CHA₂DS₂-VA Score) and Atrial Fibrillation
Clinical situation	Anticoagulant therapy
Valvular AF Mechanical valve Mitral stenosis (moderate or severe)	Warfarin (not NOAC)
Hypertrophic cardiomyopathy and AF	Preferably NOAC or Warfarin
Cardiac amyloidosis and AF	Preferably NOAC or Warfarin

NOAC – Non-vitamin K Oral Anticoagulant (Dabigatran, Rivaroxaban, Apixaban, Edoxaban)