Belangrijke wijzigingen in de NHG-standaard ‘Atriumfibrilleren’

Conflict of interest: none declared. Financial support: none declared.

• A small number of points in the NHG practice guideline ‘Atrial fibrillation’ have been reviewed; this has important consequences for general practice.

• The risk of ischaemic CVA in patients with atrial fibrillation is determined using a new risk score (CHA₂DS₂-VASc).

• The target value of the resting ventricular frequency has been increased from a maximum of 90 to a maximum of 110 beats per minute.

• Oral anticoagulants are indicated in almost all patients aged 65 years and older with atrial fibrillation; the only group in whom antithrombotic medication is not indicated is men under the age of 75 with no cardiovascular comorbidity.

• Acetylsalicylic acid for the prevention of thrombo-embolism is only indicated if oral anticoagulants are contra-indicated.

• The new oral anticoagulants (NOACs) have very limited use in the prevention of a thrombo-embolism in general practice.