The mystery of atrial fibrillation: Reduce strokes with the help of the Chinese law. Atrial fibrillation is the greatest danger to human health because it is easy to grow blood clots in the atria, and once the clot is dislodged, it will cause acute embolism in the peripheral arteries, and the embolism will cause stroke (stroke) in the brain, so patients with atrial fibrillation must be treated with effective anticoagulation to reduce stroke. Warfarin is an anticoagulant that prevents thrombosis. Which patients with atrial fibrillation need to take warfarin? Patients with atrial fibrillation are first evaluated for thromboembolic risk. Patients with atrial fibrillation who also have hypertension, diabetes mellitus, heart failure, are ≥75 years old, or have a past history of stroke/TIA, in principle, need anticoagulation. The doctor will also do a score called CHADS2-VASc, and those with a score greater than 2 are considered high risk and should be anticoagulated; if the score is ≤1 it is considered low risk and can be temporarily unanticoagulated. Warfarin is an anticoagulant that prevents intra-atrial thrombosis and can reduce the incidence of stroke by 68% and the overall morbidity and mortality rate by 33% in patients with atrial fibrillation. How do I use Warfarin? The initial dose of warfarin is 1 to 3 mg. The INR (International Normalized Ratio) of coagulation should be monitored at first once a week to reach the target range (INR 2-3) within 2 to 4 weeks, and then once a month, and the dose of warfarin should be adjusted according to the INR, and the INR should be controlled between 2.0 and 3.0. Those who are also taking Chinese herbal medicines such as Salvia, Ginkgo, Ginseng and Glycyrrhiza need to reduce the amount of warfarin and when taking American Ginseng, warfarin needs to be increased appropriately. Warfarin side effects Warfarin is like a double-edged sword, providing the benefit of stroke prevention on the one hand, and increasing the potential risk of bleeding on the other. Contraindications: before and after surgery (need to change to low molecular heparin injection transition), severe hepatic and renal impairment, uncontrolled hypertension (blood pressure ≥ 160/100mmHg), bleeding disorders, active gastric or duodenal ulcers, pregnancy, etc. INR should be measured if bleeding tendency is present and Warfarin should be temporarily discontinued. Novel anticoagulants Dabigatranate provides effective, predictable, and stable anticoagulation with fewer drug interactions, no drug-food interactions, and no need for routine coagulation monitoring or dose adjustment.