Management of Atrial Fibrillation: Guidelines From the American College of Cardiology and American Heart Association
Am Fam Physician. 2025;111(2):183-184
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• Percutaneous occlusion of the left atrial appendage reduces stroke risk and mortality with similar effectiveness as warfarin.
• Surgical exclusion of the left atrial appendage during cardiac surgery reduces stroke risk with continued anticoagulation.
• Electrical cardioversion is more effective for acute rhythm control than medications.
• Catheter ablation reduces symptoms of AF, but it recurs in up to 40% of patients.
From the AFP Editors
Atrial fibrillation (AF) is expected to impact 12 million people by 2030 and increase mortality risk by at least 1.5 times. It is a chaotic, irregular atrial rhythm caused by ectopic sources in the pulmonary veins of the left atrium or in response to reentrant cardiac conduction activity from interstitial fibrosis. The American College of Cardiology and American Heart Association (ACC/AHA) released guidelines for managing patients with AF.
EVALUATION
Clinical evaluation of newly diagnosed AF should include transthoracic echocardiography. Testing for cardiac ischemia and pulmonary embolism is recommended only if suggested by clinical presentation.
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