International Normalized Ratio (INR) Targets: Atrial Fibrillation and Flutter 

The international normalized ratio (INR) recommendations below are per guidelines from the American College of Chest Physicians (2008). ^[1]

The INR target (range) is 2.5 (2.0-3.0) in all of the following circumstances:

• Ischemic stroke, transient ischemic attack (TIA), or systemic embolism

• Risk factors (age >75 years, hypertension, diabetes mellitus, decreased left ventricular systolic function, heart failure)

• Mitral stenosis

• After open-heart surgery

• Planned cardioversion

• Emergency cardioversion

Duration of therapy

• Ischemic stroke, TIA, or systemic embolism: Long-term

• Risk factors: Long-term

• Mitral stenosis: Long-term

• After open-heart surgery: 4 weeks

• Planned cardioversion: 3 weeks prior and 4 weeks after

• Emergency cardioversion: 4 weeks