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Atrial Fibrillation Acute Management

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1. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018

are continually evolving and care for patients requires confidence in integrating these new developments into practice. These clinical practice guidelines will assist Australian practitioners in the diagnosis and management of adult patients with AF. Main recommendations: These guidelines provide advice on the standardised assessment and management of patients with atrial fibrillation regarding: screening, prevention and diagnostic work-up; acute and chronic arrhythmia management with antiarrhythmic therapy (...) National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018 National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018 | The Medical Journal of Australia mja-search search Use the for more specific terms. Title contains Body contains Date range from Date

2018 MJA Clinical Guidelines

2. Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association

on clinical risk factors, not on AF pattern. Similarly, both the EORP-AF (EURObservational Research Programme–Atrial Fibrillation) General Pilot Registry and the J-RHYTHM (Japanese Rhythm Management Trial for Atrial Fibrillation) Registry demonstrated higher death rates with nonparoxysmal AF; however, in the multivariable Cox model, nonparoxysmal AF was not an independent predictor of death during follow-up. , In the Euro Heart Survey, paroxysmal AF had comparable risk for thromboembolic events (...) a variety of methods to measure AF burden or recurrence were used. Comprehensive Risk Factor Management Australian investigators reported the results of a study in which participants with AF and body mass index (BMI) ≥27 kg/m 2 opted for comprehensive risk factor management or standard management and were followed up for 15 months, 2 years, and 5 years (LEGACY study [Long-term Effect of Goal-Directed Weight Management on Atrial Fibrillation Cohort: A 5-Year Follow-up Study]). , AF burden was measured

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2018 American Heart Association

3. Management of acute atrial fibrillation in the emergency department: a systematic review of recent studies

Management of acute atrial fibrillation in the emergency department: a systematic review of recent studies Management of acute atrial fibrillation in the emergency department: a systematic review of recent studies Management of acute atrial fibrillation in the emergency department: a systematic review of recent studies Coll-Vinent B, Fuenzalida C, Garcia A, Martin A, Miro O CRD summary This review examined recent-onset atrial fibrillation in the emergency department and concluded that atrial (...) always be relegated as a second treatment option. Research : The authors stated that large prospective randomised trials were needed to confirm the findings of this review and assess use of newer therapeutic options in emergency departments. Funding Not stated. Bibliographic details Coll-Vinent B, Fuenzalida C, Garcia A, Martin A, Miro O. Management of acute atrial fibrillation in the emergency department: a systematic review of recent studies. European Journal of Emergency Medicine 2013; 20(3): 151

2014 DARE.

4. Atrial fibrillation: management

before pacing and atrioventricular node ablation for people with paroxysmal atrial fibrillation or heart failure caused by non-permanent (paroxysmal or persistent) atrial fibrillation. [new 2014] [new 2014] 1.7 Management for people presenting acutely with atrial fibrillation Rate and rh Rate and rhythm control ythm control 1.7.1 Carry out emergency electrical cardioversion, without delaying to achieve anticoagulation, in people with life-threatening haemodynamic instability caused by new-onset (...) Atrial fibrillation: management Atrial fibrillation: management Atrial fibrillation: management Clinical guideline Published: 18 June 2014 nice.org.uk/guidance/cg180 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

5. 2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation

Ischemic Attack; NOAC, non-vitamin K antagonist oral anticoagulant; OAC, oral anticoagulant. ---- Figure 4 A summary of our recommendations for the management of antithrombotic therapy in patients with atrial fibrillation (AF) in association with Non-ST-elevation acute coronary syndrome (NSTEACS) or ST-elevation myocardial infarction (STEMI). ASA, acetylsalicylic acid (aspirin); CHADS 2 , C ongestive Heart Failure, H ypertension, A ge, D iabetes, S troke/Transient Ischemic Attack; NOAC, non-vitamin K (...) (RCTs) of various antithrombotic therapies among patients with either CAD or AF only, augmented by the results from the available RCTs and observational data from patients with concomitant AF and CAD. x 9 Lip, G.Y., Windecker, S., Huber, K. et al. Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group

2016 Canadian Cardiovascular Society

6. 2014 ESC Management of Antithrombotic Therapy in Atrial Fibrillation Patients Presenting With Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary or Valve Interventions

2014 ESC Management of Antithrombotic Therapy in Atrial Fibrillation Patients Presenting With Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary or Valve Interventions CURRENTOPINION Managementofantithrombotictherapyinatrial ?brillationpatientspresentingwithacutecoronary syndromeand/orundergoingpercutaneous coronaryorvalveinterventions:ajointconsensus documentoftheEuropeanSocietyofCardiology WorkingGrouponThrombosis,EuropeanHeart RhythmAssociation(EHRA),European (...) , acute coronary syndrome; APT, antiplatelet therapy; CABG, coronary artery bypass graft surgery; CV, cardiovascular; ICH, intracranial haemorrhage; MI, myocardial infarction; NSTEMI, non-ST elevation myocardial infarction; PROBE, prospective, randomized, open, blinded end-point; RCT, randomized controlled trial; STEMI, ST elevation myocardial infarction; TT, triple therapy; UAP, unstable angina pectoris. Antithrombotic management in atrial ?brillation patients with ACS/PCI Page11of25 by guest

2014 Heart Rhythm Society

7. Management of Antithrombotic TherApy in Patients With Atrial Fibrillation or DevelOping AtRial Fibrillation During Hospitalization for PCI

relatively frequent occurrence and the many etiologic factors involved in its pathogenetic condition, the frequency and prognostic significance of AF complicating ACS remain unclear Condition or disease Intervention/treatment Acute Coronary Syndrome Atrial Fibrillation Other: Acute coronary syndrome and PCI and AF Detailed Description: There are limited data available, particularly from a representative population-based perspective describing recent pharmacological and non-pharmacological management (...) Management of Antithrombotic TherApy in Patients With Atrial Fibrillation or DevelOping AtRial Fibrillation During Hospitalization for PCI Management of Antithrombotic TherApy in Patients With Atrial Fibrillation or DevelOping AtRial Fibrillation During Hospitalization for PCI - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study

2018 Clinical Trials

8. Metoprolol vs. diltiazem in the acute management of atrial fibrillation in patients with heart failure with reduced ejection fraction. (PubMed)

Metoprolol vs. diltiazem in the acute management of atrial fibrillation in patients with heart failure with reduced ejection fraction. The objective of this study was to examine the effects of metoprolol versus diltiazem in the acute management of atrial fibrillation (AF) with rapid ventricular response (RVR) in patients with heart failure with reduced ejection fraction (HFrEF).This retrospective cohort study of patients with HFrEF in AF with RVR receiving either intravenous push (IVP) doses (...) received metoprolol and 34 received diltiazem. The primary outcome, successful rate control within 30 min, occurred in 62% of the metoprolol group and 50% of the diltiazem group (p = 0.49). There was no difference in HR control at predefined time points or incidence of hypotension, bradycardia, or conversion. Although baseline HR varied between groups, maximum median change in HR did not differ. Signs of worsening heart failure were similar between groups.For the acute management of AF with RVR

2018 American Journal of Emergency Medicine

9. Management of Major Bleeding in Patients With Atrial Fibrillation Treated With Non-Vitamin K Antagonist Oral Anticoagulants Compared With Warfarin in Clinical Practice (from Phase II of the Outcomes Registry for Better Informed Treatment of Atrial Fibrill (PubMed)

to assess the frequency, management, and outcomes of major bleeding in the setting of community use of NOACs. Using the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry, we analyzed rates of International Society on Thrombosis and Haemostasis major bleeding and subsequent outcomes in patients treated with NOACs versus warfarin. Outcomes of interest included acute and chronic bleeding management, recurrent bleeding, thromboembolic events, and death. In total, 344 (...) Management of Major Bleeding in Patients With Atrial Fibrillation Treated With Non-Vitamin K Antagonist Oral Anticoagulants Compared With Warfarin in Clinical Practice (from Phase II of the Outcomes Registry for Better Informed Treatment of Atrial Fibrill Non-vitamin K antagonist oral anticoagulants (NOACs) are effective at preventing stroke in patients with atrial fibrillation (AF). However, little is known about the management of bleeding in contemporary, clinical use of NOACs. We aimed

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2017 American Journal of Cardiology

10. New-onset atrial fibrillation

palpitations, dyspnoea, angina, dizziness or syncope, and features of congestive heart failure (CHF), tachycardia-induced cardiomyopathy, stroke, and death. ECG shows absent P waves, presence of fibrillatory waves, and irregularly irregular QRS complexes. Most patients presenting with new-onset or 'acute' atrial fibrillation (AF) do not require immediate cardioversion. Most patients will require medical therapy to control ventricular rate. Patients who develop haemodynamic compromise should have immediate (...) is intact. Fuster V, Rydén LE, Cannom DS, et al. 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2011;123:e269-e367. http://circ.ahajournals.org/content/123/10/e269.long http://www.ncbi.nlm.nih.gov/pubmed/21382897?tool=bestpractice.com New-onset AF is defined as a new onset

2018 BMJ Best Practice

11. Intravenous Flecainide for Emergency Department Management of Acute Atrial Fibrillation. (PubMed)

Intravenous Flecainide for Emergency Department Management of Acute Atrial Fibrillation. Atrial fibrillation (AF) is the most commonly encountered dysrhythmia in the emergency department, and its prevalence is increasing. A substantial proportion of these patients have recent-onset AF (<48 h). The poor prognosis associated with AF is being increasingly recognized, and there is some evidence for better outcomes in younger patients with recent-onset AF when sinus rhythm is restored. Flecainide (...) is recommended in the latest international guidelines for cardioversion of recent-onset AF, but its safety and efficacy relative to other recommended agents are unclear.Our aim was to clarify the Level 1 evidence for the use of i.v. flecainide in acute AF.We performed a systematic review and meta-analysis of the literature. Medline, Ovid, Embase, and Cochrane Central databases were searched for relevant studies. Only randomized controlled trials (RCTs) of i.v. flecainide for acute conversion of recent-onset

2017 Journal of Emergency Medicine

12. Recent trends in management and outcome of patients with acute coronary syndromes and atrial fibrillation. (PubMed)

Recent trends in management and outcome of patients with acute coronary syndromes and atrial fibrillation. To describe the clinical characteristics, contemporary trends of in-hospital management and outcome of patients admitted for an acute coronary syndrome (ACS) with associated atrial fibrillation (AF).We analyzed data from four Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive ACS patients.Out of 16,803 ACS patients, 1019 (6.1%) presented (...) for STEMI].Over the last 14years, the in-hospital management of ACS patients with AF has significantly improved as for patients without AF, with comparable effect in terms of outcome.Copyright © 2017. Published by Elsevier B.V.

2017 International journal of cardiology

13. Acute Myocardial Infarction Due to Coronary Artery Embolism in a 22-Year-Old Woman with Mitral Stenosis with Atrial Fibrillation Under Warfarinization: Successful Management with Anticoagulation (PubMed)

Acute Myocardial Infarction Due to Coronary Artery Embolism in a 22-Year-Old Woman with Mitral Stenosis with Atrial Fibrillation Under Warfarinization: Successful Management with Anticoagulation BACKGROUND Coronary artery embolization is an exceedingly rare cause of myocardial infarction, but a few cases in association with prosthetic mechanical valves have been reported. We report a case of embolic myocardial infarction caused by a thrombus in the left atrium with deranged coagulation profile (...) in a patient with critical mitral stenosis under warfarinization. CASE REPORT A 22-year-old woman was taken to the catheterization lab for early coronary intervention in lieu of non-ST elevation myocardial infarction. Electrocardiography showed T↓ in V1 to V4, and atrial fibrillation with controlled ventricular rate. Coronary angiography showed total occlusion of the mid-left anterior descending artery with thrombus. After upstream treatment with tirofiban, the apparent thrombus was dislodged distally

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2017 The American journal of case reports

14. Atrial Fibrillation - Diagnosis and Management

) including the primary prevention of stroke and transient ischemic attack (TIA) in adults aged ≥19 years. This guideline focuses primarily on non-valvular AF. This guideline is part of the - Stroke and Atrial Fibrillation series. The series includes three other guidelines: Stroke and Transient Ischemic Attack – Acute and Long-Term Management ; Use of Non-Vitamin K Antagonist Oral Anticoagulants (NOAC) in Non-Valvular Atrial Fibrillation ; and Warfarin Therapy Management. Key Recommendations Determine (...) and specific medical circumstances of coverage depending on BC PharmaCare plan rules. Diagnostic code: 427.3, I48 Appendices Associated Documents The following documents accompany this guideline: - Stroke and Transient Ischemic Attack – Acute and Long-Term Management - Use of Non-Vitamin K Antagonist Oral Anticoagulants (NOAC) in Non-Valvular Atrial Fibrillation - Warfarin Therapy Management BC Pharmacare - Special Authority Request This guideline is based on scientific evidence current as of the Effective

2015 Clinical Practice Guidelines and Protocols in British Columbia

15. Atrial Fibrillation ? Diagnosis and Management

Fibrillation series. The series includes three other guidelines: Stroke and Transient Ischemic Attack – Acute and Long-Term Management; Use of Non-Vitamin K Antagonist Oral Anticoagulants (NOAC) in Non-Valvular Atrial Fibrillation; and Warfarin Therapy Management. Key Recommendations • Determine the patient’s cardiac stability and provide emergency stabilization if needed. • Consider all patients with atrial fibrillation for antithrombotic therapy (short and long term). • Establish the risk of stroke (...) Fibrillation Symptom Severity with the CCS-SAF Scale • Appendix D: Stroke Risk Assessment in Atrial Fibrillation: CHADS 2 Score • Appendix E: HAS-BLED Score for Major Bleeding • Appendix F: Comparisons of Anticoagulants for Atrial Fibrillation • Appendix G: Prescription Medication Table for Atrial Fibrillation Associated Documents The following documents accompany this guideline: • BCGuidelines.ca – Stroke and Transient Ischemic Attack – Acute and Long-Term Management • BCGuidelines.ca – Use of Non-Vitamin

2015 Clinical Practice Guidelines and Protocols in British Columbia

16. Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI?

Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI? Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI? - CanadiEM Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI? In , by Vinai Bhagirath March 5, 2019 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Medical Expert Main Messages P2Y12 inhibition is important (...) for the first 1-6 months after PCI insertion, and may have ongoing benefits up to 12 months or longer. Addition of anticoagulant to antiplatelet therapy increases the risk of bleeding, but reduces the risk of stroke. Use of an anticoagulant plus P2Y12 inhibitor is preferable to anticoagulant plus dual antiplatelet therapy, because of reduced bleeding risk. Case Description You are seeing a 72-year-old woman with a history of atrial fibrillation (AF), and additional stroke risk factors of hypertension

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2019 CandiEM

17. Atrial Fibrillation (Focused Update)

to the section on catheter ablation of atrial fibrillation (AF), revisions to the section on the management of AF complicating acute coronary syndrome (ACS), and new sections on device detection of AF and weight loss. The areas of the 2014 AF Guideline that were updated were limited to those for which important new data from clinical trials had emerged and/or new U.S. Food and Drug Administration (FDA) indications for thromboembolism protection devices have appeared in the data available to the writing group (...) Atrial Fibrillation (Focused Update) Accepted Manuscript 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation Craig T. January, MD, PhD, FACC, Chair, Writing Group, L. Samuel Wann, MD, MACC, FAHA, Vice Chair, Writing Group, Hugh Calkins, MD, FACC, FAHA, FHRS, Writing Group Member, Lin Y. Chen, MD, MS, FACC, FAHA, FHRS, Writing Group Member, Joaquin E. Cigarroa, MD, FACC, Writing Group Member, Joseph C. Cleveland, Jr., MD, FACC

2019 American College of Cardiology

18. WITHDRAWN: Pharmacological cardioversion for atrial fibrillation and flutter. (PubMed)

WITHDRAWN: Pharmacological cardioversion for atrial fibrillation and flutter. Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects.To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk (...) and Electrophysiology (2001, 2002).Randomised controlled trials or controlled clinical trials of pharmacological cardioversion versus rate control in adults (>18 years) with acute, paroxysmal or sustained atrial fibrillation or atrial flutter, of any duration and of any aetiology.One reviewer applied the inclusion criteria and extracted the data. Trial quality was assessed and the data were entered into RevMan.We identified two completed studies AFFIRM (n=4060) and PIAF (n=252). We found no difference in mortality

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2017 Cochrane

19. The future of atrial fibrillation management: integrated care and stratified therapy. (PubMed)

a challenge, as shown by patients who are only diagnosed with the condition when admitted to hospital for acute cardiac decompensation or stroke. Once diagnosed, atrial fibrillation requires chronic, multidimensional management in five domains (acute management, treatment of underlying and concomitant cardiovascular conditions, stroke prevention therapy, rate control, and rhythm control). The consistent provision of these treatment options to all patients with atrial fibrillation is difficult, despite (...) The future of atrial fibrillation management: integrated care and stratified therapy. Atrial fibrillation is one of the major cardiovascular health problems: it is a common, chronic condition, affecting 2-3% of the population in Europe and the USA and requiring 1-3% of health-care expenditure as a result of stroke, sudden death, heart failure, unplanned hospital admissions, and other complications. Early diagnosis of atrial fibrillation, ideally before the first complication occurs, remains

2017 Lancet

20. 2016 ACC/AHA Clinical Performance and Quality Measures for Adults With Atrial Fibrillation or Atrial Flutter

Documents Guidelines 2014 AHA/ACC/HRS Guidelines for the Management of Patients With Atrial Fibrillation 2013 ACCF/AHA Guideline for Management of Heart Failure Statements 2013 Treatment of Atrial Fibrillation , 2012 AHA/ASA Oral Antithrombotic Agents for the Prevention of Stroke in Nonvalvular Atrial Fibrillation: A Science Advisory for Healthcare Professionals 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation Recommended for Patient Selection (...) to the measure. Table 4. Revised Atrial Fibrillation Measures No. Care Setting Measure Title Rationale for Revisions PM-4 Outpatient CHA 2 DS 2 -VASc Risk Score Documented This measure was revised to reflect the update in the “2014 AHA/ACC/HRS Guideline for Management of Patients With Atrial Fibrillation” that recommends the use of the CHA 2 DS 2 -VASc score instead of the CHA 2 DS 2 . Additionally, this measure was revised to allow for a patient reason exception that reflects instances in which a patient

2016 American Heart Association

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