We recommend that when OAC-therapy is indicated for patients with non-valvular AF, most patients should receive dabigatran, rivaroxaban, apixaban or edoxaban (when approved) in preference to warfarin. (Strong Recommendation, High Quality Evidence)

Practical Tip: Non-valvular AF refers to AF in the absence of rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. A major challenge for clinicians in following this recommendation is that the current reimbursement systems in Canada are not aligned with it. A summary of the present reimbursement requirements of each province for patients who qualify for NOACs is provided in Supplemental Appendix 2.