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PRACTICE: A John Camm and Irina Savelieva Some patients with paroxysmal atrial fibrillation should carry flecainide or propafenone to self treat BMJ 2007; 334: 637 [Full text]

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CHADS 2 and atrial fibrillation

Sern H Lim   (26 March 2007)

CHADS 2 and atrial fibrillation 26 March 2007
Sern H Lim, SpR Cardiology Birmingham Send response to journal: Re: CHADS 2 and atrial fibrillation	Camm and Savalieva [1] provide a clear, concise and practical description of the "pill-in-the-pocket" approach to the treatment of paroxysmal atrial fibrillation (AF). Anticoagulation therapy is recommended for patients at high risk of thromboembolism based on the CHADS 2 risk scoring system. However, the 'A' in the CHADS 2 acronym, as initially described by Gage et al [2] referred to 'Age>75 years', and not 'Angina' as indicated. Finally, it is worth noting that the CHADS 2 scheme should not be applied to patients with AF at high risk of thromboembolism (eg: patients with mitral stenosis). 1. Camm JA, Savalieva I. Some patients with paroxysmal atrial fibrillation should carry flecainide or propafenone to self treat. BMJ 2007; 334: 637. 2. Gage BF, Waterman AD, Shannon W et al. Validation of clinical classification schemes for predicting stroke. Results from the National Registry of Atrial Fibrillation. JAMA 2001; 285: 2864-70. Competing interests: None declared