Objective: Oral anticoagulant therapy is the cornerstone of atrial fibrillation management to prevent stroke and systemic embolism.However, there is limited real-world information regarding stroke and systemic embolism prevention strategies in patients with atrial fibrillation.The aim of the ROTA study is to obtain the real-world data of anticoagulant treatment patterns in patients with atrial fibrillation. Materials and Methods:The ROTA study is a prospective, multicenter, and observational study that included 2597 patients with atrial fibrillation.The study population was recruited from 41 cardiology outpatient clinics between January 2021 and May 2021. Results:The median age of the study population was 72 years (range: 22-98 years) and 57.4% were female.The median CHA 2 DS 2 -VASc and HAS-BLED scores were 4 (range: 0-9) and 1 (range: 0-6), respectively.Vitamin K antagonists and direct oral anticoagulants were used in 15.9% and 79.4% of patients, respectively.The mean time in therapeutic range was 52.9% for patients receiving vitamin K antagonists, and 76% of those patients had an inadequate time in therapeutic range with <70%.The most common prescribed direct oral anticoagulants were rivaroxaban (38.1%), apixaban (25.5%), and edoxaban (11.2%).The rate of overuse of vitamin K antagonists and direct oral anticoagulants was high (76.1%) in patients with low stroke risk, and more than one-fourth of patients on direct oral anticoagulant therapy were receiving a reduced dose of direct oral anticoagulants.Among patients who were on direct oral anticoagulant treatment, patients with apixaban treatment were older, had higher CHA 2 DS 2 -VASc and HAS-BLED scores, and had lower creatinine clearance than the patients receiving other direct oral anticoagulants. Conclusions:The ROTA study provides important real-world information about anticoagulant treatment patterns in patients with atrial fibrillation.