I am writing this because I am amazed at how few people seem to be aware of the National Instituteof Clinical Excellence Patient decision Aid Atrial Fibrillation.
This document was written for patients being advised to take anticoagulants to make an informed choice after being given all the information.Unfortunately few Drs bother to refer patient to this advice ,either through ignorance or arrogance.It is a long document,well worth the read a few exerts I have included below
Treatment options to reduce your risk of having a stroke
Many people with AF are asked to think about taking a medicine called an ‘anticoagulant’. This is to reduce their risk of having an ischaemic stroke caused by their AF. Anticoagulants make the blood take longer to clot (sometimes called ‘thinning the blood’). This reduces the risk of a blood vessel in the brain becoming blocked by a clot. Anticoagulants also reduce the risk of blood clots causing problems elsewhere in the body. Treatment with an anticoagulant is usually long term.
You can choose whether to take an anticoagulant or not. If you decide to take one, you will then need to decide which one you want to use. This decision aid is intended to help you weigh up the options and come to a decision that is right for you.
If you choose to take an anticoagulant, you can choose warfarin or one of the newer drugs such as apixaban, dabigatran or rivaroxaban. Warfarin has been used for many years to reduce the risk of stroke in people with AF. It belongs to a group of drugs called vitamin K antagonists. Apixaban, dabigatran and rivaroxaban have become available in the past few years and work in a different way from warfarin, so they are often called the non-vitamin K oral anticoagulants, or NOACs for short.
There is a lot of information in this decision aid that you will need to think about before you decide whether to take an anticoagulant or not, and if so, which one you want to use. If you have just been diagnosed with AF you will need to make a decision soon (preferably within a few days), but most people do not have to make a decision immediately. You may want to talk your decision over with your health professional, your family or your friends. Treatment with an anticoagulant is usually long term, so it is important that you are happy with your choice. Once you have made a choice, you can change your mind later if you wish or if your situation changes. Your risk of having a stroke and having major bleeding can also change over time, so your healthcare professional will review your risk once a year. If you decide not to take an anticoagulant now, you should think about this decision again then.