A major advance in the field of anticoagulation for AFib has been the development and study of novel oral anticoagulants (NOACs). There are 3 NOACs approved in the United States for stroke prevention in patients with non-valvular AFib: dabigatran; rivaroxaban; and apixaban; plus one, edoxaban, under regulatory review at this time (August 2014; Figure 15), as well as a number that are still investigational (eg betrixaban).  The first to be approved was the oral direct thrombin inhibitor (DTI), dabigatran. The other 3 listed in Figure 15 (rivaroxaban, apixaban, and edoxaban) are all oral factor Xa inhibitors  As discussed in more detail in the following Figure, these different novel oral anticoagulants have all been studied in AFib and appear to be efficacious when compared with warfarin.