Atrial fibrillation is a clinically significant cardiac arrhythmia that increases the risk of stroke by 3 to 4 times. Oral anticoagulation has been shown to mitigate stroke risk by two-thirds among patients with AF and is widely recommended in optimizing AF management.Direct oral anticoagulants have also been demonstrated to be superior to warfarin with respect to the risk of fatal bleeding and stroke prevention.

However, the previous study finding highlighted a great gap between current guidelines and the clinical management of AF .Nonetheless, the decision for anticoagulant use is not straightforward.It is worth to investigate the updated prevalence of anticoagulant use, the reasons for not receiving anticoagulant, and the factors independently associated with anticoagulant refusal in patients with non-valvular atrial fibrillation.

Inclusion Criteria:

• diagnosis as atrial fibrillation
• aged ≧18 years
• able to given consent

Exclusion Criteria:

• Unable/unwillingness to sign informed consent to study
• mechanical heart valve
• moderate-to-severe mitral stenosis
• Transient atrial fibrillation from reversible cause (e.g., during respiratory tract infection or bronchospasm)
• pregnancy
• hospitalization within 1 month prior to inclusion in the study.

all of the documented atrial fibrillation patients having regular follow up in GOPC in the study period

no Conflict of interest