Warfarin has been the effective treatment in the prophylaxis of cardioembolism, 
in particular in patients with atrial fibrillation, for more than 50 years. 
Nevertheless, many patients with atrial fibrillation are not currently treated 
because of the numerous limits of oral anticoagulation and in those treated the 
quality of anticoagulation is often poor. Novel oral anticoagulant drugs, the 
direct thrombin antagonist dabigatran and factor Xa inhibitors such as 
rivaroxaban, apixaban, edoxaban, and betrixaban are more predictable and 
convenient anticoagulants in comparison with warfarin, mainly because of the 
non-requirement of regular laboratory monitoring and dose adjustments. Current 
data from phase III clinical trials are available for dabigatran, rivaroxaban 
and apixaban, which show to be at least noninferior in efficacy to warfarin for 
the prevention of stroke in patients with atrial fibrillation. This review 
focuses on the potential of novel anticoagulants to replace warfarin in patients 
with atrial fibrillation. Also the place in therapy and the potential 
limitations of the new agents in clinical practice represent important issues to 
be considered. The promise of new oral anticoagulants gives us the hope that 
warfarin will finally be replaced in a near future, but more importantly that 
anticoagulant undertreatment of atrial fibrillation will be partially overcome.