The TROMBIX-DZ study tracked 398 Algerian patients with atrial fibrillation treated with rivaroxaban for one year, finding treatment-emergent serious adverse events in just 1.76% of patients. Major bleeding occurred at 2.1 events per 100 patient-years, while thromboembolic events were even rarer at 0.9 per 100 patient-years. Most patients (71.9%) received the standard 20mg daily dose, with 75.88% continuing treatment through the study period. This represents the first comprehensive real-world evidence from the Maghreb region on direct oral anticoagulants for stroke prevention in atrial fibrillation. The safety profile aligns closely with established international registries, suggesting rivaroxaban's benefits translate across diverse populations. However, the study's observational design limits causal conclusions, and the relatively small cohort may not capture rare adverse events. Treatment persistence below 80% indicates room for improvement in patient adherence strategies. As a preprint awaiting peer review, these findings require validation before informing clinical guidelines. The research fills a crucial gap in North African cardiovascular data, potentially supporting broader access to modern anticoagulation therapy in underrepresented populations where stroke prevention remains a significant public health challenge.