Managing Outcomes in Atrial Fibrillation

Atrial fibrillation is the most common serious abnormal heart rhythm. This microsite will feature the latest developments in atrial fibrillation treatment modalities, guidelines, and best practices to ensure the proper management of this potentially deadly condition.
American College of Cardiology Issues New Atrial Fibrillation Treatment Guidelines

American College of Cardiology Issues New Atrial Fibrillation Treatment Guidelines

  • Use the CHA2DS2-VASc score for determining which patients are at greatest risk of stroke.
  • Clinicians should take an individualized approach to antithrombotic therapy.
  • Strict rate control is preferred over lenient.
  • Catheter ablation is a first-line option.
Let the Patient Decide: Postoperative A-Fib Rhythm and Rate Strategies Are Equivalent

Let the Patient Decide: Postoperative A-Fib Rhythm and Rate Strategies Are Equivalent

  • New multinational study of more than 500 patients found no clear superiority of either strategy.
  • The incidence of serious thromboembolic events was low, 2%, and did not differ between the arms.
  • More patients in the rate control arm met protocol-specified indications for anticoagulation compared with the rhythm control arm.
This Procedure Is Now First-Line A-Fib Therapy: New ACC Guidelines

This Procedure Is Now First-Line A-Fib Therapy: New ACC Guidelines

  • Recent guidelines from the American college of Cardiology offer important revisions regarding the management of atrial fibrillation.
  • Ablation is now a first-line therapy.
  • Cardiologists should now use the more precise risk stratification scoring system.
  • Tight heart rate control is preferred over lenient control.
  • Antithrombotic therapy is to be individualized based on shared decision-making between patient and physician.
Predicting Risk in AF: Which Stratification Scheme Performs Best?

Predicting Risk in AF: Which Stratification Scheme Performs Best?

  • The CHA2DS2-VASc is better at discriminating truly low-risk patients and finding those at high risk as well.
  • In the first validation study from the EuroHeart survey, CHA2DS2-VASc had a similar C statistic to CHADS2 but improved prediction in truly low-risk patients and classified only a small proportion into the intermediate-risk category.
  • the more precise the risk tool is to assess future risk of stroke, the better the chance that low-risk patients can avoid anticoagulation and that those who will benefit from anticoagulation will be identified accurately.
  • The major weakness of CHADS2 is that a substantial proportion of patients (approximately 60%) are assigned a score of 1, indicating an intermediate risk of stroke, and the benefit of application of anticoagulation to this subset is uncertain.