Implications for your practice: Important changes in the 2014 guideline for the management of patients with atrial fibrillation

Abstract

Atrial fibrillation (AF) is an increasingly common cardiac arrhythmia, currently affecting more than 5 million Americans. Management of patients with AF can be complex, with key strategies including selecting rhythm control versus heart rate control and reducing the patient’s risk of stroke or other systemic embolization. The American Heart Association, American College of Cardiology, and Heart Rhythm Society released 2014 Guideline for the Management of Patients with Atrial Fibrillation, which outlines several new recommendations with important clinical implications. Among these are a new recommendation to use the CHA₂DS₂-Vasc score for stroke risk assessment, rather than the previously advised CHADS₂ score, expansion of anticoagulation options in selected patients, decreased emphasis on the role of aspirin, and an increased emphasis on the role of catheter ablation.

Keywords :

• Atrial fibrillation
• atrial flutter
• anticoagulation
• warfarin

Declaration of interest

G. Flaker has been a consultant for and received funding from Bristol Myers Squibb, Pfizer, Boehringer Ingelheim, and Daiichi Sankyo. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.