A-fib Prophylaxis Order-set or protocol

[kvl1027]

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Hello everyone, I have to come up with an A-fib prophylaxis protocol and I am having trouble figuring when a-fib prophylaxis should be initiated based on the Framingham Risk of A-fib. I just cant find anything that makes a statement about at what risk do you initiate prophylaxis.

I was wondering if anyone has initiated such a protocol at their institutions and might have some advice regarding this issue.

 

[metrarx]

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[kvl1027]

Isn't it based on the chads score?

Circulation has a good article regarding this. It's something like: selecting pts with a fib for anticoagulation.

No, this is based on the Framingham risk for getting new onset a-fib within the next 10 years. There are studies that somewhat support the practice of prophylaxing for a-fibin patients who have never had a-fib, but I'm just trying to find some data on when to start that prophylaxis, basically at what level of risk would someone require a-fib prophylaxis.

I'm having a hard time coming up with a recommendation. If anyone already has this type of protocol at your institution, some advice would be greatly appreciated.