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[Important changes in the Dutch College of General Practitioners (NHG) practice guideline 'Atrial fibrillation': revised practice guideline issued].

A small number of points in the NHG practice guideline 'Atrial fibrillation' have been reviewed; this has important consequences for general practice. The risk of ischaemic CVA in patients with atrial fibrillation is determined using a new risk score (CHA2DS2-VASc). The target value of the resting ventricular frequency has been increased from a maximum of 90 to a maximum of 110 beats per minute. Oral anticoagulants are indicated in almost all patients aged 65 years and older with atrial fibrillation; the only group in whom antithrombotic medication is not indicated is men under the age of 75 with no cardiovascular comorbidity. Acetylsalicylic acid for the prevention of thrombo-embolism is only indicated if oral anticoagulants are contra-indicated. The new oral anticoagulants (NOACs) have very limited use in the prevention of a thrombo-embolism in general practice.