64
Management
Figure 15. Flowchart: Management of Periprocedural
Anticoagulation in Patients With AF
Patients with AF undergoing
invasive procedure or surgery
Resumption of anticoagulation
the day after low bleeding
risk surgery and between the
evening of the second day and
the evening of the third day
after high bleeding risk surgery
(2a)
Procedure cannot
be performed safely
on uninterrupted
anticoagulation
Timing of interruption of
DOAC should be guided by
the specific agent, renal
function, and the bleeding
risk
(1)
Bridging with low-
molecular-weight
heparin should not be
administered (except
in patients with
mechanical valve or
recent stroke or TIA)
(3: Harm)
Temporary cessation
of oral anticoagulation
without bridging
is recommended
(excluding those with
recent stroke or TIA, or
a mechanical valve)
(1)
Holding
warfarin
