The 69-year-old male patient developed new-onset atrial fibrillation (AF) 2 days after coronary artery bypass grafting (CABG), and it recurred 2 days later. The clinical pharmacist reviewed domestic and international literature, taking into account the patient's medical history, age, and symptoms, and after assessing the risks of thrombosis and bleeding, recommended a triple antithrombotic therapy with rivaroxaban, aspirin, and ticagrelor, which the physician accepted. During hospitalization, the patient maintained sinus rhythm (70–100 beats/min) without bleeding complications. When the patient was discharged, considering that prolonged triple antithrombotic therapy could increase the risk of bleeding and that related coagulation parameters could not be monitored outside the hospital, the clinical pharmacist recommended discontinuing ticagrelor and continuing antithrombotic therapy with aspirin and rivaroxaban. The patient was instructed to follow up one month after surgery for re-evaluation and adjustment of the antithrombotic treatment, which was adopted by the physician. Clinical pharmacists assisted physicians in developing individualized antithrombotic treatment plans for patients and provided pharmaceutical care to the patients' treatment process, which effectively controlled the condition and ensured that the patients' medication was safe and effective. This case could provide a reference for the management of antithrombotic therapy in patients with new-onset AF after CABG.

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