Do I need to use warfarin or dabigatran? Patients with atrial fibrillation are at great risk of cerebral embolism, which causes serious adverse effects on the patient, family and society. Therefore, the use of anticoagulants is particularly important. Do all patients with atrial fibrillation need to be anticoagulated? Most do, and all patients with a CHA2DS2-VASc score ≥2 require anticoagulation, and patients with a score of 1 are best anticoagulated if they are at low risk of bleeding. Anticoagulants include oral anticoagulants such as warfarin or dabigatran. Warfarin is inexpensive but requires monitoring of the coagulation-related INR, while dabigatran and others do not require monitoring but are costly, at $1200 or more per month.