Since publication of the 2014 joint consensus document dealing with the management of antithrombotic therapy in atrial fibrillation (AF) patients presenting with acute coronary syndrome (ACS) and/ or undergoing percutaneous coronary (PCI) or valve interventions, which represented an effort of the European Society of Cardiology Working Group (ESC) on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA),1 endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS) there have been additional data from observational cohorts, randomized controlled trials and advances in percutaneous interventions.