Do you need to use heparin when initiating warfarin therapy in a patient with atrial fibrillation?
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Not all patients being initiated on anticoagulation therapy for atrial fibrillation require a heparin bridge. Patients with known hypercoagulable state should receive heparin during anticoagulation initiation. (SOR B, based on guidelines that incorporate medium-quality evidence.)
Evidence Based Practice 13(2): 09.