April 29, 2021 The European Heart Rhythm Association (EHRA) has come out with the fourth iteration of its practical guide on the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF), which has helped physicians deploy these medications since it first came out in 2013. Senior author Hein Heidbüchel, MD, PhD (Antwerp University Hospital, Belgium), past president of EHRA, explained that the guide is meant to supplement and not supplant clinical practice guidelines. The comprehensive document covers everything from dosing and drug-drug interactions to use in high-risk patient groups, management of bleeding, and what to do when patients undergo various procedures.