Atrial Fibrillation
Student Resources
Tools
HAS-BLED
| Purpose | Assess risk of bleed in patients with atrial fibrillation on anticoagulant therapy (for stroke prevention). |
| Type of Resource | Scoring tool |
| Included | Tool consists of risk factors associated with increased bleeding risk. Score ranges from 0-9 to classify patients into low to high bleed risk:
Provides interpretation of results and recommendation on whether to start anticoagulation therapy. |
| Student Bottom Line | When a patient is diagnosed with atrial fibrillation, use this scoring tool to determine if anticoagulation therapy is safe to initiate (based on bleeding risk). Use your clinical judgement to assess stroke risk and bleed risk. |
| VIEW RESOURCE |
CHADS2
| Purpose | Assess 1 year risk of stroke in patients with atrial fibrillation to guide need for anticoagulation therapy (similar to CHA₂DS₂-VASc). |
| Type of Resource | Scoring tool |
| Included | Tool consists of risk factors associated with increased stroke risk. Score ranges from 0-6 to classify patient into low to high risk of thromboembolic event:
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| Student Bottom Line | When a patient is diagnosed with atrial fibrillation, use this scoring tool to determine if stroke prevention therapy is necessary.
*Important to compare to bleeding risk* |
| VIEW RESOURCE |
CHA₂DS₂-VASc
| Purpose | Assess 1 year risk of stroke in patients with atrial fibrillation to guide need for anticoagulation therapy (similar to CHADS₂). |
| Type of Resource | Scoring |
| Included | Tool consists of risk factors associated with increased stroke risk. Score ranges from 0-9 to classify patient into low to high risk of thromboembolic event:
Provides recommendation on whether to start anticoagulation therapy. |
| Student Bottom Line | When a patient is diagnosed with atrial fibrillation, use this scoring tool to determine if stroke prevention therapy is necessary.
*Important to compare to bleeding risk Although there is no statistical difference between CHA₂DS₂-VASc and CHADS₂ , CHA₂DS₂-VASc is preferred.
If a patient is considered “low risk”, CHA₂DS₂-VASc can better assess the need for anticoagulation (ex. Patient may have a score of 0 with CHADS₂ but CHA₂DS₂-VASc may be different). |
| VIEW RESOURCE |
SPARCtool
| Purpose | Assess both the risk and benefits of starting anticoagulation therapy in patients with atrial fibrillation. |
| Type of Resource | Scoring tool |
| Included | Combination of both CHA₂DS₂-VASc (stroke risk) and HAS-BLED (bleeding risk).
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| Student Bottom Line | If you are interested in calculating both stroke and bleed risk in AF patients, this quick and easy tool will not only calculate the scores but will also assess the benefit and risk of specific drug therapies and overall benefit.
If you are interested in the interpretation of CHA₂DS₂-VASc and HAS-BLED scores, it is best to use their individual scoring tools. |
| VIEW RESOURCE |
Tisdale Risk Score for QT prolongation
| Purpose | Predicts risk of QT prolongation. |
| Type of Resource | Scoring Tool |
| Included | Includes risk factors and provides a risk score based on the information inputted. |
| Student Bottom Line | Risk of QT prolongation is an important consideration in AF. Many medications can cause QT prolongation so this scoring tool is handy to use to assess the severity of the risk. |
| VIEW RESOURCE |
Guidelines
The Canadian Cardiovascular Society Guidelines
| Purpose | Guide treatment recommendations for patients diagnosed with atrial fibrillation. Includes treatment for both acute symptoms and long term rate and rhythm control. |
| Type of Resource | Canadian Guidelines (updated frequently – last update 2020) |
| Included |
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| Student Bottom Line | The recommended resource to guide treatment for patients diagnosed with atrial fibrillation. The flowcharts and algorithms in the pocket guide are a great tool for studying and practicum purposes. For more details and information, the full guidelines are preferred. |
| VIEW RESOURCE (full guidelines) – VIEW RESOURCE (pocket guidelines) |
Credible Meds
| Purpose | Provides QT drug risk. |
| Type of Resource | Informative resource (requires making an account) |
| Included | Type in medication to assess the QT risk. |
| Student Bottom Line | We recommend using the information on this website in addition to the Tisdale risk score tool to assess QT prolongation risk. |
| VIEW RESOURCE |