Atrial Fibrillation Guidelines 2014
The “2014 Guideline for the Management of Patients with Atrial Fibrillation” was created to reflect the latest research when it comes to treating atrial fibrillation—an irregular heart rhythm affecting 2.6 million Americans. Released in March 2014 by the American College of Cardiology, American Heart Association and Heart Rhythm Society in collaboration with the Society of Thoracic Surgery, this document incorporates knowledge from the latest research to provide recommendations for the management of atrial fibrillation. It helps answer questions like “How can patients with atrial fibrillation prevent stroke?” and “How can I estimate a patient’s risk for complications?”. Here’s what every patient should know about the latest atrial fibrillation guidelines:
Calculating Stroke Risk: Stroke is the most common type of serious complication associated with atrial fibrillation. Certain factors can further increase risk for stroke, such as high blood pressure, so it’s important to identify those at highest risk for stroke and take action to reduce risk of complications. In the past, experts have used a simple risk calculator to assess stroke risk. However, new guidelines recommend using a more detailed risk calculator that provides more information and can more accurately identify those at low, moderate and high risk for stroke.
Reducing Risk for Stroke: Aside from lifestyle changes, medication is one of the best ways to reduce stroke risk in patients with atrial fibrillation. Patients with a history of stroke are at higher risk for a future cardiac event, so anti-clotting medication (oral anticoagulation) is recommended. Previously, coumadin (warfarin) was the only recommended anti-clotting drug, but experts expanded the list to newer drugs including dabigatran, rivaroxaban and apixaban.
Aspirin Use: Past guidelines recommended that patients with low cardiovascular risk should take aspirin as an added precaution to help prevent stroke. This recommendation was removed in the 2014 guidelines based on lack of data linking aspirin use to reduced stroke risk.
Ablation Therapy: Radiofrequency ablation therapy is a non-surgical procedure that can help relieve symptoms and improve quality of life in certain patients with atrial fibrillation. During ablation, tiny areas of the heart are destroyed to help prevent electrical impulses that can trigger an abnormal heart beat. The 2014 guidelines encourage broader use of this treatment for certain patients with atrial fibrillation.
Read the full guidelines in the Journal of the American College of Cardiology