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In final guidance published today (15 March) NICE has recommended dabigatran (Pradaxa, Boehringer Ingelheim), in accordance with its licensed indications, as an option for the prevention of stroke and systemic embolism in people with atrial fibrillation. The guidance also recommends that the decision about whether to start treatment with dabigatran should be made after an informed discussion about the risks and benefits of dabigatran compared with warfarin, and in light of a person's current level of international normalised ratioi (INR) control if they are already taking warfarin.

Publication of the final guidance follows the dismissal on all points of an appeal against the draft guidance.

Atrial fibrillation occurs when the electrical impulses controlling the heart rhythm become disorganised, so that the heart beats irregularly and, occasionally, too fast and so cannot efficiently pump blood around the body. People with atrial fibrillation are at higher risk of developing blood clots and subsequent stroke - however, the risk of stroke can be substantially reduced by appropriate use of antithrombotic therapy (e.g. warfarin).

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