The incidence of atrial fibrillation (AF), as well as the related morbidity and mortality, is increasing in step with the aging of the US population. Frequently, AF leads to untoward outcomes, including a 5-fold increased risk of stroke, hospitalization, impaired quality of life, and decreased work productivity. Therapeutic decision making for patients with AF at risk for stroke is a process that varies from one physician to the next. This lack of consistency in care is compounded by disrupted communication among caregivers coupled with barriers to health care resources. Improved application of evidence-based treatment guidelines for the diagnosis, staging, and tracking of AF-associated stroke is needed, especially because patients with AF are at high risk. In addition to affecting practice guidelines, the latest anticoagulants are poised to change the standard of care for preventing stroke in patients with AF. These novel agents, with their greater safety and ease of administration, have the potential to improve treatment outcomes.