A writing group identified 20 topics of concrete clinical scenarios for which practical answers were formulated, based on available evidence. The European Heart Rhythm Association (EHRA) set out to coordinate a unified way of informing physicians on the use of the different NOACs. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF) and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. The current manuscript is the second update of the original Practical Guide, published in 2013.

14 Antwerp University and University Hospital, Antwerp, Belgium.

13 Cardiology Clinical Academic Group, Molecular & Clinical Sciences Institute, St George's University, London, UK, and Imperial College.

12 Age-Related Health Care & Stroke-Service, Tallaght Hospital, Dublin Ireland.

10 University of Murcia, Murcia, Spain.

9 Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.

8 Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden.

7 Center for Stroke Research Berlin and Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

6 Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.

5 City Hospital Braunschweig, Braunschweig, Germany.4 Grenoble-Alps University Hospital, Grenoble, France.3 School of Medicine, Belgrade University, Belgrade, Serbia.2 Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.

1 Department of Cardiology, University Heart Center Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland.

Antz 2