Stroke prevention in atrial fibrillation has always required a trade-off between preventing clot and provoking bleeding. Factor XI inhibition may change that equation. This roundtable will examine whether this emerging drug class can deliver effective stroke prevention with a lower bleeding burden, which patients may benefit most, how the latest trial evidence should be interpreted, and where Factor XI inhibitors could sit alongside established anticoagulants and left atrial appendage occlusion.
