Figure 1.

Recommended algorithm for management of atrial fibrillation in people with hemophilia without inhibitors.⁶³ The primary determinant of management of AF in PWH is the baseline FVIII/FIX level (ie, hemophilia severity). People with severe hemophilia are considered candidates for thromboprophylaxis provided they are receiving factor concentrate prophylaxis. The decision to initiate antithrombotic therapy is further based on the individual projected risk for stroke, in this case determined by the CHADS₂ scoring system. A score of ≥2 is considered indicative of a high risk for stroke. (See text for a description of the CHADS₂ score calculation.) CFC indicates clotting factor concentrate; CHADS₂, congestive heart failure, hypertension, age, diabetes mellitus, stroke; FVIII, factor VIII; FIX, factor IX; PWH, people with hemophilia. Republished with permission of Blood: Journal of the American Society of Hematology, from “How I treat age-related morbidities in elderly persons with hemophilia,” Mannucci, PM, et al.,114, 26 © 2009; permission conveyed through Copyright Clearance Center, Inc.