Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major 
risk factor for stroke. For more than 60 years, warfarin has been the only 
approved anticoagulant for prevention of stroke in patients with AF. Although 
highly effective, it has many limitations that make its use difficult. 
Therefore, several novel anticoagulants are under development to overcome the 
limitations of warfarin, and some of these have entered phase III clinical 
trials. Dabigatran is an oral, reversible direct thrombin inhibitor approved in 
Europe and in several other countries for the prevention of venous 
thromboembolism after elective knee and hip replacement surgery. It has also 
been approved in the United States and Japan for the prevention of stroke and 
systemic embolism in patients with nonvalvular AF. In this review, the mechanism 
of action and pharmacological properties of new anticoagulants are described in 
detail, and the correct use of dabigatran in clinical practice is discussed.