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The paradigm for atrial fibrillation (AF) management has changed significantly in recent years. A new era has begun for the prevention of one of the most tremendous complication of AF, stroke. Prevention of ischemic stroke in AF patients with oral anticoagulants represents a huge challenge because of the narrow therapeutic change of these drugs, interindividual and intraindividual variability, and the unsatisfactory time in therapeutically range (TTR) with this type of medication.

New guidelines have emerged as a result of new mechanisms for initiation and perpetuation for...