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Warfarin is recommended for the treatment of non-dialysis patients with AF to prevent thrombotic complications (17). However, in a study that followed up 1671 dialysis patients with AF over a mean period of 16?years, the risk of de novo stroke was 193 times higher in warfarin users than in non-users, and the risk of stroke increased 279 times in patients using warfarin without monitoring the PT-INR compared with patients not using warfarin (18). The Dialysis Outcomes and Practice Patterns Study (DOPPS) also reported that warfarin was administered in 16% of patients with AF but the risk of stroke increased 217 times in warfarin users aged 75?years and above (19). However, the above results http://www.selleckchem.com/products/poziotinib-hm781-36b.html were those of observational studies, and thus larger-scale interventional studies are necessary in the future to evaluate the usefulness of warfarin. Until then, warfarin must be used carefully in dialysis patients with AF. False elevations of the PT-INR are observed frequently during dialysis, and they are reportedly caused by inappropriate blood sampling using an indwelling catheter (20). We recommend that blood used for the determination of PT-INR be collected directly from a blood vessel. Defibrillation is attempted by medication or electric shock. The indications for electric defibrillation are the following: (i) http://en.wikipedia.org/wiki/MYO10 severe tachycardiac atrial fibrillation not responding to medications accompanied by progressive myocardial ischemia, symptomatic hypotension, angina pectoris, or heart failure, (ii) severe tachycardiac atrial fibrillation or unstable hemodynamics, and (iii) intolerable clinical symptoms due to atrial fibrillation despite stable hemodynamics (17). Antiarrhythmic drugs described in the present guidelines are used for defibrillation, but monitoring http://www.selleckchem.com/products/bay80-6946.html of the dose, blood concentration of the drug during treatment, and ECG recording are necessary in treated patients, because all such drugs have arrhythmia-inducing effects by prolonging the QT interval or extending the QRS duration. One meta-analysis that compared the rhythm control and heart rate control in non-dialysis patients with AF showed no significant difference in mortality rate, incidence of non-CNS bleeding, and incidence of ischemic stroke except that the proportion of patients who required hospitalization was significantly lower in the heart rate control group (P?