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.

Stroke risks and patterns of warfarin therapy among atrial fibrillation patients post radiofrequency ablation

“…The 2014 American College of Cardiology/American Heart Association (ACC/AHA)/Heart Rhythm Society guideline has emphasized the use of catheter ablation in selected patients as first-line therapy for paroxysmal AF and also recommended the use of the CHA2DS2-VASc score for risk stratification of stroke. [ 4 ]…”