Table 5.
When to restart OAC according to international guidelines.
| Guidelines | Year | Class of Recommendation (Level of evidence) | Resumption Recommendations |
|---|---|---|---|
| ACC Expert Consensus (158) | 2017 | – | Multidisciplinary approach for high-risk cases, 4-week waiting for DOACs |
| CHEST Guideline (117) | 2018 | Ungraded consensus-based statement | From 48 h to 4 weeks based on individual risk/benefit evaluation. DOAC preferred. LAA occlusion for high recurrent ICH risk |
| ESO-Karolinska Stroke Update (159) | 2019 | C | 4–8 week waiting, individual decision-making, DOACs for NVAF |
| ESC Guidelines (82) | 2020 | IIa (C) IIb (B) |
OACs re-initiation (2–4 weeks), after careful evaluation of individual risks and benefits, DOACs preferred. LAA occlusion for high recurrent ICH risk. |
| EHRA Practical Guide (160) | 2021 | – | 4–8 week waiting after multidisciplinary team assessment, consider no anticoagulation or LAAO |
ACC, American College of Cardiology; CHEST, American College of Chest Physicians; DOACs, Direct oral anticoagulants; NVAF, Non-valvular Atrial Fibrillation; LAAO, Left Atrial Appendage Occlusion; EHRA, European Heart Rhythm Association.