CHADS-65 Score for Atrial Fibrillation
Canadian Cardiovascular Society simplified stroke risk score for atrial fibrillation. Recommends anticoagulation based on age ≥65 or any CHADS risk factor.
Score interpretation
→ CHADS-65 ≥1 (or age ≥65): Oral anticoagulation recommended. Prefer DOAC over warfarin (rivaroxaban, apixaban, dabigatran, edoxaban) unless contraindicated. Assess bleeding risk before prescribing.
→ CHADS-65 = 0 (and age <65): Low stroke risk. Anticoagulation not recommended. Reassess annually or if clinical status changes. Rhythm control may be considered.
Interpretation bands for the CHADS-65. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- CHA₂DS₂-VASc Score · Atrial Fibrillation
- ORBIT Bleeding Risk Score for AF · Atrial Fibrillation
- CHA₂DS₂-VA Score for AF (2023) · Atrial Fibrillation
- CHADS-65 for Atrial Fibrillation · Atrial Fibrillation
- GARFIELD-AF Risk Score for Atrial Fibrillation · Atrial Fibrillation
- CHARGE-AF Score for Incident Atrial Fibrillation · Atrial Fibrillation
- Edoxaban (AF Stroke Prevention / VTE) · Direct Factor Xa Inhibitor (DOAC)
- Clopidogrel (Stroke/TIA Secondary Prevention) · Antiplatelet (P2Y12 Inhibitor)
- Dabigatran (Stroke Prevention — AF) · Direct Oral Anticoagulant — Thrombin Inhibitor
- Rivaroxaban (Stroke Prevention — AF) · Direct Oral Anticoagulant — Factor Xa Inhibitor
- Edoxaban (Stroke Prevention) · Stroke Prevention
- Rivaroxaban · Direct Oral Factor Xa Inhibitor — VTE / PAD / AF Stroke Prevention
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The CHADS-65 is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.