www.CHESTERCMS.org The American Heart Association's guidelines are similar but they do not give preference of anticoagulants and leave a CHA2DS2-VASc score of 1 to the physician's discretion whether to anticoagulate or use antiplatelet therapy. The importance of this model is exhibited in the image below and as you can see the adjusted stroke rate increases from less than 2% with a score of 0 to almost 20% with a score of 6. Left atrial appendage occlusion has tentative evidence to reduce risk of stroke but studies are in progress to make it more mainstream therapy. Summary There are other models available but currently CHA2DS2VASc is universally accepted and followed. The European Society guideline algorithm is given below; they prefer everyone with a CHA2DS2-VASc score of 1 or more to receive anticoagulation and they prefer newer anticoagulants over warfarin and use warfarin as an alternate. 10 CHESTER COUNT Y Medicine | SUMMER 2017 Atrial fibrillation is a very complex and important medical ailment and results in extensive mortality and morbidity. We have attempted to explain its etiology, pathogenesis, diagnosis, and management with special attention to anticoagulants. This article was a collaboration between Mian A. Jan, MD an interventional cardiologist practicing in Chester County, and Zarshawn Jan, a third- year medical student at Drexel University College of Medicine.http://chestercms.org/index.html