Guidelines on managing anticoagulated patients undergoing endoscopic procedures are timely and welcome (Veitch et al, Gut 2008;57:1322–9). Non-valvular atrial fibrillation is increasingly prevalent with advanced age and is the most common reason for warfarin therapy. The risks of thromboembolic events when briefly interrupting warfarin in patients with non-valvular fibrillation are small, but perhaps not so different to those of interrupting warfarin in patients with a mechanical cardiac valve to recommend differences in bridging the …