Summary: For patients with atrial fibrillation who are on oral anticoagulation, not using peri-procedural “bridging” anticoagulation with heparins (either low-molecular weight or unfractionated) may actually decrease the risk of bleeding events as well as myocardial infarction, stroke or systemic embolism, major bleeding, hospitalization, or death within 30 days. (In other words, peri-procedural use of “bridging” anticoagulation with heparins appears to be associated with an increased risk of bleeding events as well as myocardial infarction, stroke or systemic embolism, major bleeding, hospitalization, or death within 30 days.)

http://www.ncbi.nlm.nih.gov/m/pubmed/25499873/

Strength of Recommendation = B

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