In AF patients on antithrombotic prophylaxis with an NOAC, we suggest preoperative management without bridging (Weak recommendation, low quality evidence). The Patient Patient knowledge and understanding of the stroke risk associated with AF and the bene t of OAC to prevent stroke are crucial to patient acceptance of anticoagulants, as well as adherence, and life-long persistence (in most cases), to OAC. However, research demonstrates that AF patients generally have poor awareness and knowledge about their condition,467-472 medications used to treat AF, particularly OAC, and do not clearly comprehend the bene t/risk associated with stroke prevention regimens.203,468-471,473-478 Although there is increasing advocacy from clinical and expert consensus2,203,479 to incorporate patient preferences for treatment into the decision-making process, a patient s ability to make an informed decision may be hindered by their lack of understanding about the relationship between AF and stroke and the ef cacy/safety of OAC for stroke prevention, particularly at diagnosis, when these decisions are invariably addressed. Assessment of patient s knowledge (using the AF Knowledge or Jessa Atrial Fibrillation Knowledge ), as well as their values and preferences, could be undertaken to ascertain gaps to be lled; this may lead to better decision-making and improved adherence and persistence. Patient education is essential to provide patients with suf cient information to enable them to make an informed decision about whether they wish to take OAC, and if they do, which OAC they would prefer.203,476,482 Education needs to be tailored to the person s desire for information and their level of health literacy to promote patient understanding. 