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Balancing the Risk of Hemorrhage vs Thromboembolism in Patients With Atrial Fibrillation: How To Navigate Between Scylla and Charybdis?

Giuseppe Boriani, MD, PhD; Igor Diemberger, MD, PhD; Mauro Biffi, MD; Cristian Martignani, MD, PhD
Author and Funding Information

Correspondence to: Giuseppe Boriani, MD, PhD, Institute of Cardiology, University of Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Via Massarenti 9 40138 Bologna-Italy; e-mail: giuseppe.boriani@unibo.it


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(5):1032-1033. doi:10.1378/chest.10-0808
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Extract

According to mythology, Scylla and Charybdis were two sea monsters placed on opposite sides of the Strait of Messina, between Calabria and Sicily in Italy. Sailors’ navigation was extremely difficult since these monsters were very close to each other and attempts to avoid Scylla implied passing very closely to Charybdis and vice versa. This imaginary scenario well depicts the difficulties that a practicing physician may encounter when deciding on the intriguing trade-off between benefits and risks of antithrombotic prophylaxis in the challenging and complex setting of “real-world” patients affected by nonvalvular atrial fibrillation (AF).1

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