Atrial Fibrillation — EECC MCQ

Correct answer: A — A DOAC after stabilisation

When AF persists after an acute trigger, anticoagulation is based on stroke risk; DOACs are preferred for most once clinically stable. Prolonged heparin infusions are not used. Antiplatelets are inadequate; warfarin is not mandatory unless indicated. The keyed option is the best answer only in the stated clinical context. The alternatives would require different findings, contraindications, thresholds or treatment circumstances that are not present. Apply the recommendation alongside comorbidity, interactions, patient preference and the current local pathway. Review response and safety-net for deterioration, treatment failure or adverse effects; reconsider the diagnosis if the expected response does not occur. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: ACC/AHA/ACCP/HRS Guideline (2023): Atrial Fibrillation: https://bnf.nice.org.uk/drugs/warfarin-sodium/