It depends on your age as the main factor. I'm 51 and have Lone Afib. I take a low dose aspirin along with my Toprol and Digoxin. Over 65 you're more likely to be put on Warfarin (Coumadin). I think at more advanced age other risk factors come into play. They usually take the most conservative approach that's effective. If you're at a younger age and your doc prescribes Aspirin therapy, it's for a reason. The reason being that Aspirin will do the trick.
Aspririn is far more convenient and safer to administer. Coumadin requires diet restrictions and periodic testing (PT/INR checked weekly or monthly) and occasional dose adjustments. If you accidently let your PT/INR rise above safe levels you could have serious bleeding problems and complications. If it drops too low, you are at risk of a stroke.
As Uboat said, there are risk factors (age, BP, prior stroke, etc.) that greatly increase your chances of clotting/stroke and so coumadin is indicated. Your cardiologist assesses these and determines if you can get by safely with just aspirin or if coumadin/warfarin need be prescribed. Here is how the medhelp cardiologist answered a similar question to yours.
BTW I've been on coumadin for over 5 years and would much rather be on aspirin. On the other hand, I don't want to get a stroke either and it's not too inconvenient.
I have been on Coumadin for nearly 15 years. I fretted over it when I first started, but became glad that I was taking it when weighing the alternative (Stroke). I asked the EP why those people on Aspirin therapy did not have to take Protime/INR tests and he replied that it was because Aspirin did not change thickness of the blood sufficiently to require a test. I would prefer to have my blood thined to INR between 2 and 3 than have whatever Aspirin does to it.
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