The most common sustained arrhythmia, atrial fibrillation (AF), is the focus of a 2023 guideline from the American College of Cardiology (ACC) and American Heart Association (AHA) Joint Committee on Clinical Practice Guidelines. The incidence and prevalence of AF is increasing in the U.S. and globally, the authors note.
“With the emergence of new and consistent evidence, this guideline emphasizes the importance of early and continued management of patients with AF that should focus on maintaining sinus rhythm and minimizing AF burden,” according to 1 of 10 top take-home messages. “Catheter ablation of AF receives a Class 1 indication as first-line therapy in selected patients,” according to another key message.
Oral anticoagulation is a core element in the prevention of thromboembolism portion of the report. The use of vitamin K antagonists, direct oral anticoagulants, and reversal agents is detailed. Another major section covers rhythm control, the use of antiarrhythmic agents, and the use of anticoagulants before and after catheter ablation.
Editorial: “The new 2023 ACC/AHA/ACCP/HRS Guideline provides comprehensive guidance for the classification, diagnosis, and management of AF,” editorialists write. “When managing a patient with AF, it is essential to consider the individual patient’s treatment goals, symptoms, comorbidities, AF burden, and stroke and bleeding risk. By doing so, clinicians can provide optimal care and improve patient outcomes. Regardless of the treatment strategy pursued, the guideline also highlights again the importance of shared decision-making.”