The newest clinical guideline released by the ACC and the American Heart Association (AHA) provides new and updated recommendations for preventing and optimally managing atrial fibrillation (AFib).
The 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation updates two separate guidelines from 2014 and 2019, respectively, and includes new recommendations addressing AFib and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, AFib catheter or surgical ablation, as well as risk factor modification and prevention.
Among the highlights, are a stronger, more prescriptive focus on healthy lifestyle habits to prevent or lessen the burden of AFib across the disease continuum, including weight loss, physical activity, smoking cessation, alcohol moderation, hypertension and other comorbidities. Use of clinical care pathways, such as nurse-led AFib clinics, is also reasonable, according to the guideline, when it comes to “promoting comprehensive, team-based care and to enhance adherence to evidence-based therapies for AFib and associated conditions.”
The guideline also sets forth a new way to classify AFib, using stages that reinforce the continuum of the disease and underscore the need to use a variety of strategies, including prevention, lifestyle and risk factor modification, screening, and therapy. Additionally, early and more aggressive rhythm control in general is addressed, along with upgraded recommendations for catheter ablation as first-line therapy to prevent disease progression in select patients, including those with heart failure with reduced ejection fraction.