(Section 4.1. in the 2014 AF Guideline) I C In patients with AF, anticoagulant therapy should be individualized on the basis of shared decision-making after discussion of the absolute risks and relative risks of stroke and bleeding, as well as the patient s values and preferences. MODIFIED: Antithrombotic was changed to anticoagulant. I C For patients with atrial flutter, anticoagulant therapy is recommended according to the same risk profile used for AF. MODIFIED: Antithrombotic was changed to anticoagulant. I C Reevaluation of the need for and choice of anticoagulant therapy at periodic intervals is recommended to reassess stroke and bleeding risks. MODIFIED: Antithrombotic was changed to anticoagulant. I C-EO For patients with AF (except with moderate-to-severe mitral stenosis or a mechanical heart valve) who are unable to maintain a therapeutic INR level with warfarin, use of a NOAC is recommended. MODIFIED: Exclusion criteria are now defined as moderate-to-severe mitral stenosis or a mechanical heart valve, and this recommendation has been changed in response to the approval of edoxaban. (Section 4.1. in the 2014 AF Guideline) IIa B For patients with AF (except with moderate- to-severe mitral stenosis or a mechanical heart valve) and a CHA2 -VASc score of 0 in men or 1 in women, it is reasonable to omit anticoagulant therapy.S4.1.1-24,S4.1.1-25 MODIFIED: Exclusion criteria are now defined as moderate-to-severe mitral stenosis or a mechanical heart valve. (Section 4.1. in the 2014 AF Guideline) IIb B-NR For patients with AF who have a CHA2 - VASc score of 2 or greater in men or 3 or greater in women and who have end-stage chronic kidney disease (CKD; creatinine clearance [CrCl] <15 mL/min) or are on dialysis, it might be reasonable to prescribe warfarin (INR 2.0 to 3.0) or apixaban for MODIFIED: New evidence has been added. 