What is recommended for patients with paroxysmal AF to reduce stroke risk?
For patients with AF, including those with paroxysmal AF, stroke risk should be assessed using a risk factor based approach, rather than an categorization into low, moderate/high risk strata. We recommend use of the CHA2DS2-VASc as a simple clinical based stroke risk score to initially identify low stroke risk patients who should not be offered antithrombotic therapy to prevent stroke and reduce mortality. Subsequent to this initial step, for patients with AF, including those with paroxysmal AF, stroke prevention should be offered to those AF patients with one or more non-sex CHA2DS2-VASc stroke risk factors (score of 1 in a male or 2 in a female).