Today, I saw several patients with atrial fibrillation, both persistent and paroxysmal, because the incidence of atrial fibrillation increases significantly with age, and with the advent of an aging society in China, atrial fibrillation as an arrhythmia is becoming more and more common. The main question that most patients are concerned about and struggle with is: Do I need anticoagulation therapy? What kind of anticoagulant should I take? Do I need anticoagulation therapy? In fact, doctors do not just decide to give anticoagulation to patients. Before anticoagulation, the risk of thrombosis should be assessed first, referring to the international common assessment system – CHA2DS2-VASc, which scores multiple factors such as cardiac function, hypertension, age, diabetes, stroke, vascular disease, gender, etc. If the score is 0, oral bye aspirin can be taken and anticoagulation is not required. If the score is 0, the patient can take oral aspirin without anticoagulation; if the score is ≥2, anticoagulation such as warfarin, or a new oral anticoagulant should be administered; if the score is 1, the patient can take either oral anticoagulant or aspirin. Patients can do a score themselves according to the table below to see if they need anticoagulation therapy. Which anticoagulant is better to take? There are currently two types of oral anticoagulants: vitamin K antagonists (warfarin), and non-vitamin K antagonists (newer oral anticoagulants). Warfarin is widely used in clinical practice because of its low cost and clear anticoagulant effect. The dosage needs to be individualized and adjusted according to the prothrombin time, and the INR is maintained at 2.0~3.0. The dose-effect relationship of warfarin is influenced by many factors such as genetic factors, environmental factors, food, and medications, and the INR fluctuates greatly, so close monitoring is required. New oral anticoagulants NOACs. dabigatran, rivaroxaban, apixaban and edoxaban. These anticoagulants are gaining popularity among more and more patients because they do not require INR testing, but their use in clinical practice is not popular at present due to their high price. For dosing, dabigatran and apixaban are given orally every 12 hours; rivaroxaban and edoxaban are given once daily at a fixed time. Patients taking this class of drugs should have their renal function monitored regularly and their use should be reduced or discontinued when conditions such as decreased renal function or increased risk of bleeding occur. Bay aspirin. Patients with atrial fibrillation who do not have the conditions to monitor INR levels, patients in remote areas with limited transportation, elderly and frail patients with mobility problems, patients who cannot regularly go to the hospital to have their INR measured, and patients who do not have the financial means to take new oral anticoagulant drugs, can also take aspirin to prevent thrombosis. In conclusion, the clinical situation should be analyzed on a case-by-case basis, taking into account individualized treatment under the principle of following the guidelines, so as to maximize the benefits for patients.