Navid Radfar: Moving Beyond CHA₂DS₂-VASc and De-Risking Atrial Fibrillation
Navid Radfar, Incoming Cardiology Fellow at Rutgers Health, shared on LinkedIn about a recent article he and his colleagues co-authored, published in American Journal of Cardiovascular Drugs, adding:
”Excited to share our new publication, ‘De-risking Atrial Fibrillation: Refining Anticoagulation Decision-Making,’ is now published in the American Journal of Cardiovascular Drugs.
Atrial fibrillation is the most common arrhythmia and a leading cause of stroke.
For years, we’ve decided who needs a blood thinner using one clinical checklist: the CHA₂DS₂-VASc score.
But does it really capture everything about a patient?
It’s practical, widely used, and has helped countless patients — yet it has a blind spot. It treats complex variables as simple yes/no boxes, and it can’t see the structure or function of the heart itself.
In this paper, my co-authors and I make the case for a more personalized approach we call ‘de-risking’ — using advanced imaging (left atrial strain, volume index, and appendage morphology), circulating biomarkers, and AI-enabled tools to refine who truly benefits from anticoagulation, and who may be exposed to bleeding risk without much to gain.
We also synthesize lessons from landmark trials (ARTESIA, NOAH-AFNET 6, and ALONE-AF) that collectively reinforce a key idea: anticoagulation decisions should follow individualized risk–benefit assessment, not arrhythmia detection alone.”
Title: De-risking Atrial Fibrillation: Refining Anticoagulation Decision-Making
Authors: Navid Radfar, Dhir Gala, Harsh Singh, Juan Bello, Joseph Allencherril
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