CC BY-NC-ND 4.0 · Thromb Haemost 2022; 122(01): 020-047
DOI: 10.1055/s-0041-1739411
Review Article

2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary[*]

Tze-Fan Chao
1   Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2   Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
Boyoung Joung
3   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Yoshihide Takahashi
4   The Department of Advanced Arrhythmia Research, Tokyo Medical and Dental University, Tokyo, Japan
Toon Wei Lim
5   National University Heart Centre, National University Hospital, Singapore
Eue-Keun Choi
6   Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Yi-Hsin Chan
7   Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
8   College of Medicine, Chang Gung University, Taoyuan, Taiwan
9   Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
10   Pulmonary Vessel and Thrombotic Disease, Chinese PLA General Hospital, Beijing, China
Charn Sriratanasathavorn
11   Her Majesty Cardiac Center, Siriraj, Thailand
Seil Oh
6   Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Ken Okumura
12   Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
13   Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
14   Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
› Author Affiliations


The consensus of the Asia Pacific Heart Rhythm Society (APHRS) on stroke prevention in atrial fibrillation (AF) has been published in 2017 which provided useful clinical guidance for cardiologists, neurologists, geriatricians, and general practitioners in the Asia-Pacific region. In these years, many important new data regarding stroke prevention in AF were reported. The practice guidelines subcommittee members comprehensively reviewed updated information on stroke prevention in AF, and summarized them in this 2021 focused update of the 2017 consensus guidelines of the APHRS on stroke prevention in AF. We highlighted and focused on several issues, including the importance of the AF Better Care pathway, the advantages of non-vitamin K antagonist oral anticoagulants (NOACs) for Asians, the considerations of use of NOACs for Asian AF patients with single one stroke risk factor beyond gender, the role of lifestyle factors on stroke risk, the use of oral anticoagulants during the “coronavirus disease 2019” pandemic, etc. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician's decision remains the most important factor in the management of AF.

* This is an executive summary of the full consensus guideline, which is published in Journal of Arrhythmia by Chao et al. [6]

Note: The review process for this paper was fully handled by Christian Weber, Editor-in-Chief.

Supplementary Material

Publication History

Received: 15 October 2021

Accepted: 20 October 2021

Article published online:
13 November 2021

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