Summary: For patients with atrial fibrillation who need interruption of warfarin therapy for an elective surgery, use of “bridging” anticoagulation with dalteparin (100 IU/kg for 3 days before and then 5 to 10 days after the procedure) may be associated with no improvement in arterial thromboembolism prevention but an increased risk of major bleeding when compared to a no-bridging approach. (In other words, avoiding use of dalteparin “bridging” anticoagulation when warfarin is interrupted for a procedure appears to be associated with LESS risk of bleeding, and is NOT inferior at preventing thromboembolism).

Strength of Recommendation = B