Atrial fibrillation (AF) increases the risk of development of blood clots in the atria. When the atria are fibrillating and not pumping blood effectively, blood may pool in parts of the atria. A blood clot that forms and breaks loose could travel to the brain causing a stroke or damage to parts of body by blocking blood supply in arteries to them 


Warfarinis most common and cheapest one . Unlike most medications, the dose of warfarin is adjusted according to blood test results; therefore, the dose may change over time. The blood test used to monitor the thinness or thickness of the blood is referred to as the INR, or International Normalized Ratio. It is important to monitor the INR (at least once a month for most patients) to ensure that the level of warfarin is in the effective range. If the INR is too low, blood clots will not be prevented, and if the INR is too high, there is an increased risk of bleeding.

To prevent the risk of stroke in AF the blood needs to be two - three times thinner, so that it takes two to three times longer to clot i.e. has an INR of 2 to 3. By measuring the INR, anticoagulant clinics ensure that your blood is thinned to just the right amount. Too little warfarin and you won’t have the full benefit of preventing strokes, whereas too much warfarin (INR more than 3) thins the blood too much and can put you at risk of bleeding heavily when you cut yourself and of bruising badly when you fall.


Newer anticoagulants unlike warfarin these class of drugs do not need INR monitoring and are free from dietary restrictions and certain drug interactions but are slightly costly as compared to warfarin. Your electrophysiologist will choose the best and safest of all available options for you.


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