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Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects.

Rienstra, M; Tzeis, S; Bunting, KV; Caso, V; Crijns, HJGM; De Potter, TJR; Sanders, P; Svennberg, E; Casado-Arroyo, R; Dwight, J; et al. Rienstra, M; Tzeis, S; Bunting, KV; Caso, V; Crijns, HJGM; De Potter, TJR; Sanders, P; Svennberg, E; Casado-Arroyo, R; Dwight, J; Guasti, L; Hanke, T; Jaarsma, T; Lettino, M; Løchen, M-L; Lumbers, RT; Maesen, B; Mølgaard, I; Rosano, GMC; Schnabel, RB; Suwalski, P; Tamargo, J; Tica, O; Traykov, V; Kotecha, D; Van Gelder, IC (2024) Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects. Europace, 26 (12). euae298. ISSN 1532-2092 https://doi.org/10.1093/europace/euae298
SGUL Authors: Rosano, Giuseppe Massimo Claudio

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Abstract

Atrial fibrillation (AF) remains the most common cardiac arrhythmia worldwide and is associated with significant morbidity and mortality. The European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) have recently released the 2024 guidelines for the management of AF. This review highlights 10 novel aspects of the ESC/EACTS 2024 Guidelines. The AF-CARE framework is introduced, a structural approach that aims to improve patient care and outcomes, comprising of four pillars: [C] Comorbidity and risk factor management, [A] Avoid stroke and thromboembolism, [R] Reduce symptoms by rate and rhythm control, and [E] Evaluation and dynamic reassessment. Additionally, graphical patient pathways are provided to enhance clinical application. A significant shift is the new emphasis on comorbidity and risk factor control to reduce AF recurrence and progression. Individualized assessment of risk is suggested to guide the initiation of oral anticoagulation to prevent thromboembolism. New guidance is provided for anticoagulation in patients with trigger-induced and device-detected sub-clinical AF, ischaemic stroke despite anticoagulation, and the indications for percutaneous/surgical left atrial appendage exclusion. AF ablation is a first-line rhythm control option for suitable patients with paroxysmal AF, and in specific patients, rhythm control can improve prognosis. The AF duration threshold for early cardioversion was reduced from 48 to 24 h, and a wait-and-see approach for spontaneous conversion is advised to promote patient safety. Lastly, strong emphasis is given to optimize the implementation of AF guidelines in daily practice using a patient-centred, multidisciplinary and shared-care approach, with the simultaneous launch of a patient version of the guideline.

Item Type: Article
Additional Information: © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Atrial fibrillation, Guidelines, Management, Humans, Atrial Fibrillation, Practice Guidelines as Topic, Risk Factors, Anticoagulants, Catheter Ablation, Thromboembolism, Risk Assessment, Cardiology, Anti-Arrhythmia Agents, Comorbidity, Stroke, Treatment Outcome, Europe, Humans, Atrial Fibrillation, Thromboembolism, Anti-Arrhythmia Agents, Anticoagulants, Catheter Ablation, Treatment Outcome, Risk Assessment, Risk Factors, Cardiology, Comorbidity, Europe, Practice Guidelines as Topic, Stroke, Atrial fibrillation, Management, Guidelines, 1103 Clinical Sciences, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Cardiovascular & Genomics Research Institute
Academic Structure > Cardiovascular & Genomics Research Institute > Experimental Cardiology
Journal or Publication Title: Europace
ISSN: 1532-2092
Language: eng
Publisher License: Creative Commons: Attribution 4.0
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PubMed ID: 39716733
Web of Science ID: WOS:001382400300001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/117055
Publisher's version: https://doi.org/10.1093/europace/euae298

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