2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

. Author manuscript; available in PMC: 2024 May 15.

Published in final edited form as: Circulation. 2023 Nov 30;149(1):e1–e156. doi: 10.1161/CIR.0000000000001193

Recommendations for Management of Patients With AF and ICH

Referenced studies that support the recommendations are summarized in the Online Data Supplement.

COR	LOE	Recommendations
2a	C-LD	1. In patients with AF and conditions associated with very high risk of thromboembolic events (>5%/year), such as rheumatic heart disease or a mechanical heart valve, early (1–2 weeks) resumption of anticoagulation after ICH is reasonable to reduce the risk of thromboembolic events.¹
2b	C-LD	2. In patients with AF and ICH, delayed (4–8 weeks) resumption of anticoagulation may be considered to balance the risks of thromboembolic and hemorrhagic complications after careful risk benefit assessment.^2–5
2b	B-NR	3. In patients with AF and conditions associated with high risk of recurrent ICH (eg, cerebral amyloid angiopathy) anticoagulation-sparing strategies (eg, LAAO) may be considered to reduce the risk of recurrent hemorrhage.^6,7