Anticoagulation In Atrial Fibrillation - The Choice Of Bulgarian Physicians In 2015 And 2017

Atrial fibrillation is a disease of great social importance, with the number of people affected, as a result of ageing populations in Europe and globally. Therapeutic options for reducing the risk of stroke and systemic embolism are vitamin K antagonists (VKAs) and non-vitamin K antagonist oral anticoagulants (NOACs). The choice in ESC's guidelines from 2010-supplemented 2012 is according to whether the AF is valvular/non-valvular, indicating that it is necessary to clarify the definition of VAF. To avoid the slight ambiguity of the term VAF, in the ESC recommendations of 2016, it was replaced with a recommendation for VKA in patients with mechanical heart valve or moderate to severe mitral stenosis. A survey of Bulgarian doctors treating atrial fibrillation (AF) was conducted in 2015 and in 2017, one year after the publication of ESC's new recommendations, about choosing between different options for stroke prevention and systemic embolism. We find that the percentage of physicians who opted for a therapeutic option according to the 2016 recommendations is much higher than in 2015, and this may be due to the clear definition of therapeutic behaviour with the avoidance of the term nonvalvular atrial fibrillation (NVAF), and the increased attention paid to atrial fibrillation in continuing medical education.