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With great interest we read the recent European Society of Cardiology (ESC) guidelines for the Management of Atrial Fibrillation.1 We are, however, concerned about the high number of conflicts of interest (COIs) of the authors as listed in the Table 1 . Of 17 authors only 2 (12%) indicated no COI. The chairperson of the task force had the second most COIs ( n = 30). The mean number of COIs of all …

With interest we read the article by Beyer-Westendorf et al. 1 about drug persistence with rivaroxaban therapy in atrial fibrillation patients—results from the Dresden non-interventional oral anticoagulation registry. In the registry, 1204 rivaroxaban-treated patients with atrial fibrillation were observed during a mean time of 544 days. The discontinuation rate of rivaroxaban was 15% in the first year of treatment, and thus lower than in previous studies investigating patients treated with vitamin K antagonists (VKAs). We have the following questions and concerns: How did the authors ascertain that the patients were indeed taking the drug? Whereas adherence to VKA is easily monitored by measuring the international normalized ratio (INR), a test for rivaroxaban effect is not available. Were …