I believe ranolazine has been underappreciated as an AAD, and, despite it not being FDA-approved for arrhythmia suppression, it is worthy of concern, both in patients with normal and in those with somewhat reduced ventricular function, respectively. One additional new AAD observation worthy of comment from 2018 relates to the novel concept of intranasal administration of an AAD for rhythm control. new guidelines-style updates deserving NU 6102 of comment are the 2018 European Heart Rhythm Association (EHRA) Practical Guide on the Use of Nonvitamin-K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation (AF)1 and the Antithrombotic Therapy for AF: CHEST Guideline and Expert Panel Report,2 both of which were published in August 2018. To quote portions of the abstract from your EHRA document so as to show its thoroughness and appropriateness: nonvitamin-K antagonist [VKA] OACs [NOACs] are an alternative [to] VKAs to prevent stroke in patients with AF and have emerged as the preferred choice, particularly in patients newly started on anticoagulation however, many unresolved questions on how to optimally use these brokers in specific clinical situations remain. The EHRA NU 6102 set out to coordinate a unified way of informing physicians on NU 6102 the use of the different NOACs. A writing group recognized 20 topics of concrete clinical scenarios for which practical answers were formulated, based on available evidence. The 20 topics are as follows: (1) eligibility for NOACs; (2) practical start-up and follow-up plan for patients on NOACs; (3) ensuring adherence to prescribed OAC intake; (4) switching between anticoagulant regimens; (5) pharmacokinetics and drugCdrug interactions of NOACs; (6) NOACs in patients with chronic kidney or advanced liver disease; (7) how to measure the anticoagulant effect of NOACs; (8) rare indications, precautions, and potential pitfalls for NOAC plasma level measurement; (9) how to deal with dosing errors; (10) what to do if there is a (suspected) overdose without bleeding or when a clotting test is usually indicating a potential risk of bleeding; (11) management of bleeding under NOAC therapy; (12) patients undergoing a planned invasive process, surgery or ablation; (13) patients requiring an urgent surgical intervention; (14) managing patients with AF and coronary artery disease; (15) avoiding confusion with NOAC dosing across indications; (16) performing cardioversion in a NOAC-treated patient; (17) managing patients Cdkn1b with AF presenting with acute stroke while on NOACs; (18) using NOACs in special situations; (19) employing anticoagulation in patients with AF with a malignancy; and (20) optimizing dose adjustments of VKAs. This practical guideline is usually highly useful; is quite encompassing; and, in my opinion, is as appropriate for the United States (US) audience as it is for the European one. I encourage all physicians who prescribe an OAC or care for patients on an OAC to familiarize themselves with this document and keep it as a handy reference in their desk or on their office computer. Notably, the CHEST statement2 resembles that of the EHRA in most respects. Similarly included among its recommendations is a recommendation to use the CHA2DS2-VASc score in patients with AF to estimate the risk of ischemic stroke and systemic embolism. Furthermore, for patients with nonvalvular AF who are at a low risk of stroke (denoted by a CHA2DS2-VASc score of 0 in men and 1 in women, respectively), no OAC is necessary. For patients with nonvalvular AF who have one or more CHA2DS2-VASc risk factors unrelated to sex, OAC rather than no therapy, aspirin NU 6102 therapy, or dual antiplatelet therapy should be used. When selecting an OAC, the statement suggests using a NOAC rather than dose-adjusted VKA therapy in eligible patients. For patients with prior unprovoked bleeding, bleeding on warfarin therapy, or who are at high risk for bleeding, it is specifically suggested that apixaban, edoxaban, or dabigatran 110 mg (where available) be used. The CHEST document also discusses OAC and cardioversion and OAC plus.