Management of atrial fibrillation: What is new in the 2014 ACC/AHA/HRS guideline?

Postgrad Med. 2015 May;127(4):396-404. doi: 10.1080/00325481.2015.1022495. Epub 2015 Mar 7.

Abstract

Recently, the American College of Cardiology, the American Heart Association, and the Heart Rhythm Society published an updated guideline on the management of atrial fibrillation (AF). This document is a complete revision of the 2006 guideline. Prominent changes in the 2014 guideline include the use of the CHA2DS2-VASc score for risk stratification of stroke, recommendations on when and how to use newer oral anticoagulants for thromboprophylaxis, downgrading of the use of aspirin for thromboprophylaxis of moderate-risk patients, and the use of catheter ablation in selected patients as first-line therapy for paroxysmal AF. In regard to rate control, the 2014 guideline reverts back to a previous recommendation for stricter targets for mean and maximum heart rate on therapy. The current guideline incorporates many recent trials in updating existing recommendations from the 2006 guideline. The 2014 guideline will be a vital tool in guiding physicians in the management of AF.

Keywords: Atrial fibrillation; anticoagulation; catheter ablation; guidelines.

Publication types

  • Review

MeSH terms

  • American Heart Association
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / therapy*
  • Catheter Ablation
  • Guidelines as Topic*
  • Humans
  • Societies, Medical
  • United States

Substances

  • Anti-Arrhythmia Agents