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Pharmaceuticals 2012, 5, 384-397; doi:10.3390/ph5040384 OPEN ACCESS Pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review Stroke Prevention in Atrial Fibrillation: Latest Clinical Trials and Guidelines Luciana Armaganijan 1, Dimpi Patel 2, Cristiano Dietrich 3 and Carlos A. Morillo 4,* 1 Cardiac Arrhythmias and Electrophysiology, Dante Pazzanese Institute of Cardiology, Sao Paulo 04012-180, Brazil 2 1506 Bristol Court, Elizabethtown, KY 42701, USA 3 Department of Medicine, Cardiology Division, Electrophysiology Service, Paulista School of Medicine, UNIFESP, Sao Paulo 04024-002, Brazil 4 Department of Medicine, Cardiology Division, Arrhythmia Service, McMaster University, Population Health Research Institute, Hamilton, ON L8L 2X2, Canada * Author to whom correspondence should be addressed; E-Mails: morillo@hhsc.ca; morillc@mcmaster.ca; Carlos.Morillo@phri.ca; Tel.: +1-905-527-4322 (ext. 40311); Fax: +1-905-407-5499. Received: 15 March 2012; in revised form: 16 March 2012 / Accepted: 28 March 2012 / Published: 5 April 2012 Abstract: Atrial Fibrillation (AF) is the most common sustained arrhythmia and 1/6 strokes is attributed to AF. The cornerstone of treatment remains maintaining sinus rhythm or appropriate ventricular rate control in addition to prevention of stroke. Oral anticoagulation therapy (OAC) with vitamin K antagonists (VKAs) has been the gold standard for almost 50 years and a significant reduction in the risk of stroke in patients with AF has been demonstrated. Nonetheless