Table 1.

Valvular indications and contra-indications for NOAC therapy in atrial fibrillation patients

	Eligible	Contra-indicated
Mechanical prosthetic valve		✓
Moderate-to-severe mitral stenosis (usually of rheumatic origin)		✓
Mild-to-moderate other native valvular disease	✓
Severe aortic stenosis	✓ Limited data Most will undergo intervention
Bioprosthetic valvea	✓ (except for the first 3 months post-operatively)
Mitral valve repaira	✓ (except for the first 3–6 months post-operatively)
PTAV and TAVI	✓ (but no prospective data; may require combination with single or double antiplatelets: consider bleeding risk)10
Hypertrophic cardiomyopathy	✓ (but no prospective data)

PTAV, percutaneous transluminal aortic valvuloplasty; TAVI, transcatheter aortic valve implantation.

^aAmerican guidelines do not recommend NOAC in patients with biological heart valves or after valve repair.¹²