Guidelines Updated for Prevention, Management of Atrial Fibrillation

TUESDAY, Dec. 5, 2023 (HealthDay News) -- In a clinical practice guideline issued by the American College of Cardiology/American Heart Association and published online Nov. 30 in the Journal of the American College of Cardiology and Circulation, updated recommendations are presented for the prevention and optimal management of atrial fibrillation (AF).

José A. Joglar, M.D., from UT Southwestern Medical Center in Dallas, and colleagues conducted a comprehensive literature review and updated recommendations for the diagnosis and treatment of AF.

The authors developed new classifications of the stages of AF, which recognize AF as a disease continuum that requires a variety of strategies at the different stages. Lifestyle and risk factor modification is recognized as a pillar of AF management that can prevent onset, progression, and adverse outcomes; risk factor management is emphasized throughout the disease continuum, and the guideline offers more prescriptive recommendations, including obesity management, weight loss, physical activity, and smoking cessation. Recommendations for anticoagulation are made based on yearly thromboembolic event risk using a validated clinical risk score. Patients at intermediate-to-low (<2 percent) annual risk for ischemic stroke can benefit from consideration of factors that may modify their risk, including AF characteristics, sex, and blood pressure control. The importance of early and continued management of patients with AF, which should focus on maintaining sinus rhythm and minimizing AF burden, is emphasized in the guideline.

"The new guideline reinforces the urgent need to approach a-fib as a complex cardiovascular condition that requires disease prevention, risk factor modification, as well as optimizing therapies and patients' access to care and ongoing, long-term management," Joglar said in a statement.

The guideline was developed in collaboration with and endorsed by the American College of Clinical Pharmacy and the Heart Rhythm Society. Several committee members disclosed ties to the biopharmaceutical, medical technology, and publishing industries.

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