CHADS-65 — Atrial Fibrillation Anticoagulation Decision Guideline (Canadian)

The CHADS-65 algorithm is a simplified 2016 Canadian Cardiovascular Society (CCS) AF guideline recommendation for atrial fibrillation (AF) anticoagulation decision-making in adults. It replaces the older CHA₂DS₂-VASc scoring system with a streamlined, binary decision framework: (1) Is the patient ≥ 65 years AND/OR does the patient have any ONE of C-H-A-D-S risk factors (Congestive Heart Failure, Hypertension, Age ≥ 75, Diabetes, Stroke/TIA/thromboembolism)? If either criterion is met → anticoagulate. The simplification was designed to improve clinical implementation and reduce systematic under-anticoagulation, which remains problematically high in North American clinical practice.