European and American guidelines advise the use of new anticoagulation therapy in patients affected by atrial fibrillation, and in clinical practice many cardiologists us these drugs currently. Till now, the Italian drug agency authorizes the prescription only for non valvular atrial fibrillation. What should be called non-valvular atrial fibrillation has been the subject of debate in recent years in the literature (1-6).
From 2012 to date, numerous revisions of the European guidelines on atrial fibrillation have been published and in each of them the indication field for anticoagulation by NOAC have progressively expanded (1-6).
However, many of the considerations in the guidelines are still based today on the opinions of experts: in fact there are insufficient data about the use of NOAC in patients with biological vavular prosthesis and atrial fibrillation (1-5).
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