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Circulation Jan 2024The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients...
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
AIM
The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation.
METHODS
A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate.
STRUCTURE
Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.
Topics: Humans; American Heart Association; Atrial Fibrillation; Cardiology; Risk Factors; Thromboembolism; United States
PubMed: 38033089
DOI: 10.1161/CIR.0000000000001193 -
International Journal of Molecular... Dec 2021Atrial fibrillation (AF) is the most frequent arrhythmia managed in clinical practice, and it is linked to an increased risk of death, stroke, and peripheral embolism.... (Review)
Review
Atrial fibrillation (AF) is the most frequent arrhythmia managed in clinical practice, and it is linked to an increased risk of death, stroke, and peripheral embolism. The Global Burden of Disease shows that the estimated prevalence of AF is up to 33.5 million patients. So far, successful therapeutic techniques have been implemented, with a high health-care cost burden. As a result, identifying modifiable risk factors for AF and suitable preventive measures may play a significant role in enhancing community health and lowering health-care system expenditures. Several mechanisms, including electrical and structural remodeling of atrial tissue, have been proposed to contribute to the development of AF. This review article discusses the predisposing factors in AF including the different pathogenic mechanisms, sedentary lifestyle, and dietary habits, as well as the potential genetic burden.
Topics: Atrial Fibrillation; Gene Regulatory Networks; Genetic Predisposition to Disease; Health Care Costs; Humans; Life Style; Risk Factors
PubMed: 35008432
DOI: 10.3390/ijms23010006 -
European Heart Journal Mar 2023Postoperative atrial fibrillation (POAF) is the most common type of secondary atrial fibrillation (AF) and despite progress in prevention and treatment, remains an... (Review)
Review
Postoperative atrial fibrillation (POAF) is the most common type of secondary atrial fibrillation (AF) and despite progress in prevention and treatment, remains an important clinical problem for patients undergoing a variety of surgical procedures, and in particular cardiac surgery. POAF significantly increases the duration of postoperative hospital stay, hospital costs, and the risk of recurrent AF in the years after surgery; moreover, POAF has been associated with a variety of adverse cardiovascular events (including stroke, heart failure, and mortality), although it is still unclear if this is due to causal relation or simple association. New data have recently emerged on the pathophysiology of POAF, and new preventive and therapeutic strategies have been proposed and tested in randomized trials. This review summarizes the current evidence on the pathogenesis, incidence, prevention, and treatment of POAF and highlights future directions for clinical research.
Topics: Humans; Atrial Fibrillation; Cardiac Surgical Procedures; Length of Stay; Postoperative Complications; Risk Factors
PubMed: 36721960
DOI: 10.1093/eurheartj/ehad019 -
Circulation Research Jun 2020Accompanying the aging of populations worldwide, and increased survival with chronic diseases, the incidence and prevalence of atrial fibrillation (AF) are rising,... (Review)
Review
Accompanying the aging of populations worldwide, and increased survival with chronic diseases, the incidence and prevalence of atrial fibrillation (AF) are rising, justifying the term global epidemic. This multifactorial arrhythmia is intertwined with common concomitant cardiovascular diseases, which share classical cardiovascular risk factors. Targeted prevention programs are largely missing. Prevention needs to start at an early age with primordial interventions at the population level. The public health dimension of AF motivates research in modifiable AF risk factors and improved precision in AF prediction and management. In this review, we summarize current knowledge in an attempt to untangle these multifaceted associations from an epidemiological perspective. We discuss disease trends, preventive opportunities offered by underlying risk factors and concomitant disorders, current developments in diagnosis and risk prediction, and prognostic implications of AF and its complications. Finally, we review current technological (eg, eHealth) and methodological (artificial intelligence) advances and their relevance for future prevention and disease management.
Topics: Artificial Intelligence; Atrial Fibrillation; Cardiometabolic Risk Factors; Humans; Preventive Health Services
PubMed: 32716709
DOI: 10.1161/CIRCRESAHA.120.316340 -
Australian Journal of General Practice Oct 2019Atrial fibrillation (AF) is increasingly common among Australia's ageing population and carries significant morbidity and mortality. Its detection through screening,...
BACKGROUND
Atrial fibrillation (AF) is increasingly common among Australia's ageing population and carries significant morbidity and mortality. Its detection through screening, cardiac device interrogation and/or symptoms of AF brings with it a number of significant clinical issues.
OBJECTIVE
The aim of this article is to outline a systematic approach to the management of patients with AF, including the initial investigations required, rhythm versus rate control, anticoagulation for stroke prevention, and the interplay between AF and heart failure.
DISCUSSION
Most patients with AF can be managed safely and effectively in the primary care setting. Rhythm control is pursued early in certain patients with AF who are at risk of decompensated heart failure. Specialist cardiology input is important in the treatment of AF coinciding with clinical heart failure, and for patients with medically refractory symptoms or slow/rapid heart rates.
Topics: Anticoagulants; Atrial Fibrillation; Cardiovascular Agents; Catheter Ablation; Electric Countershock; Electrocardiography, Ambulatory; Exercise Therapy; Healthy Lifestyle; Heart Failure; Humans; Pacemaker, Artificial; Risk Factors; Stroke
PubMed: 31569325
DOI: 10.31128/AJGP-12-18-4787 -
Clinical Medicine (London, England) Sep 2023Atrial fibrillation (AF) is the most common cardiac arrhythmia and imposes a significant healthcare burden. The landscape of AF has changed considerably over the past... (Review)
Review
Atrial fibrillation (AF) is the most common cardiac arrhythmia and imposes a significant healthcare burden. The landscape of AF has changed considerably over the past few years, with the advent of novel diagnostic approaches, advances in therapies and changing recommendations on best practice from the latest major trials. In this article, we review our evolving understanding of the natural history of AF and explore the contemporary landscape of its diagnosis and management.
Topics: Humans; Atrial Fibrillation; Catheter Ablation
PubMed: 37775166
DOI: 10.7861/clinmed.2023-23.5.Cardio2 -
The Korean Journal of Internal Medicine May 2023Although some clinical trials have demonstrated reduced incidence of cardiovascular disease with the use of omega-3 fatty acids, others have found an increased risk of... (Review)
Review
Although some clinical trials have demonstrated reduced incidence of cardiovascular disease with the use of omega-3 fatty acids, others have found an increased risk of atrial fibrillation (AF). AF is the most common sustained cardiac arrhythmia worldwide. It is associated with high morbidity and mortality rates and significant public health burden. Previous studies of the effect of omega-3 fatty acids on AF occurrence have reported contradictory results. Here we reviewed the effect of omega-3 fatty acids on the risk of AF.
Topics: Humans; Atrial Fibrillation; Fatty Acids, Omega-3; Incidence
PubMed: 36514212
DOI: 10.3904/kjim.2022.266 -
Trends in Cardiovascular Medicine Nov 2021Patients with atrial fibrillation experience higher mortality rates than those without this condition. Recent studies have explored whether mortality rates in atrial... (Review)
Review
Patients with atrial fibrillation experience higher mortality rates than those without this condition. Recent studies have explored whether mortality rates in atrial fibrillation patients and the overall impact of atrial fibrillation on mortality has changed. Overall, mortality in atrial fibrillation has decreased over the last few decades, with no strong differences between men and women. These improvements could be caused by advances in preventing thromboembolic complications of atrial fibrillation or better management of comorbidities in these patients. Understanding the mechanisms for these changes and developing novel approaches to improve survival in AF patients are areas deserving of future research.
Topics: Atrial Fibrillation; Comorbidity; Female; Humans; Male; Risk Factors; Thromboembolism
PubMed: 33127438
DOI: 10.1016/j.tcm.2020.10.010 -
European Journal of Human Genetics :... Jul 2021Atrial fibrillation (AF) is the most common type of arrhythmia. Epidemiological studies have documented a substantial genetic component. More than 160 genes have been... (Meta-Analysis)
Meta-Analysis Review
Atrial fibrillation (AF) is the most common type of arrhythmia. Epidemiological studies have documented a substantial genetic component. More than 160 genes have been associated with AF during the last decades. Some of these were discovered by classical linkage studies while the majority relies on functional studies or genome-wide association studies. In this review, we will evaluate the genetic basis of AF and the role of both common and rare genetic variants in AF. Rare variants in multiple ion-channel genes as well as gap junction and transcription factor genes have been associated with AF. More recently, a growing body of evidence has implicated structural genes with AF. An increased burden of atrial fibrosis in AF patients compared with non-AF patients has also been reported. These findings challenge our traditional understanding of AF being an electrical disease. We will focus on several quantitative landmark papers, which are transforming our understanding of AF by implicating atrial cardiomyopathies in the pathogenesis. This new AF research field may enable better diagnostics and treatment in the future.
Topics: Alleles; Atrial Fibrillation; Genetic Association Studies; Genetic Predisposition to Disease; Genetic Variation; Genome-Wide Association Study; Genotype; Humans; Multifactorial Inheritance; Phenotype; Polymorphism, Single Nucleotide
PubMed: 33279945
DOI: 10.1038/s41431-020-00784-8 -
Journal of the American College of... Jul 2019
2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Topics: Atrial Fibrillation; Humans; Thromboembolism
PubMed: 30703431
DOI: 10.1016/j.jacc.2019.01.011