2026 Asia Pacific Heart Rhythm Society (APHRS) Guidelines (Part II) on Stroke Prevention in Atrial Fibrillation

The 2026 Asia Pacific Heart Rhythm Society (APHRS) Guidelines represent the first comprehensive APHRS guidelines dedicated to the management of atrial fibrillation (AF) and comprise four parts covering epidemiology, detection/screening and integrated care; stroke prevention; rate and rhythm control; and lifestyle risk factor and comorbidity management. Part II focuses on stroke prevention in AF, integrating contemporary global evidence with data and clinical considerations specific to the Asia-Pacific region. It provides evidence-based and practical recommendations for stroke and bleeding risk assessment, oral anticoagulation, selection and appropriate dosing of direct oral anticoagulants, management of patients with special or complex clinical characteristics, and left atrial appendage occlusion. Particular attention is given to issues (and evidence) highly relevant to Asia-Pacific populations, including the evolving risk of ischemic stroke, appropriate anticoagulant dosing, renal function assessment, and balancing thromboembolic and bleeding risks. These recommendations aim to support individualized clinical decision-making, promote appropriate use of stroke-prevention strategies, and improve outcomes for patients with AF across the Asia-Pacific region.