Figure 9. Practical management algorithm in light of the 2018 American College of Chest Physicians guidelines, which are evidence based and GRADE.

AF = atrial fibrillation; INR = international normalized ratio; NOAC = non-vitamin K antagonist oral anticoagulant; OAC = oral anticoagulation therapy.

^*HAS-BLED: hypertension, abnormal renal/liver function (1 point each), stroke, bleeding history or predisposition, labile INR, elderly (0.65), drugs/alcohol concomitantly (1 point each).