Canadian Journal of Cardiology publishes new atrial fibrillation guidelines

The Canadian Journal of Cardiology has published a focused update to the Canadian Cardiovascular Society's atrial fibrillation guidelines.

Atrial fibrillation is the most common cardiac arrhythmia and is a significant cause of stroke, illness in general, and death. It is, for example, the leading cause of stroke in the elderly. The past year has seen important changes in the drugs available to treat atrial fibrillation and in our understanding of their indications and complications. These changes will strongly affect how doctors treat this important condition. The Canadian Cardiovascular Society has accordingly updated its guidelines for drugs to prevent strokes and to control the heart rhythm, providing important new guidance to practicing doctors as to how to treat the condition, prevent potentially serious negative consequences, and avoid complications of therapy.

"These Canadian Cardiovascular Society guidelines provide the first detailed analysis of how the mass of recently obtained important information should be applied to change the ways that doctors handle this challenging clinical problem. They will have a significant impact on how the condition is treated worldwide," comments Stanley Nattel, MD, Editor-in-Chief of the Canadian Journal of Cardiology.

The paper is "Focused 2012 Update of the Canadian Cardiovascular Society Atrial Fibrillation Guidelines: Recommendations for Stroke Prevention and Rate/Rhythm Control," by Allan C. Skanes, MD, Jeff S. Healey, MD, MSc, John A. Cairns, MD, Paul Dorian, MD, Anne M. Gillis, MD, M. Sean McMurtry, MD, PhD, L. Brent Mitchell, MD, Atul Verma, MD, Stanley Nattel, MD, and the Canadian Cardiovascular Society Atrial Fibrillation Guidelines Committee (DOI: 10.1016/j.cjca.2012.01.021). It appears in Canadian Journal of Cardiology, Volume 28, Issue 2 (March 2012), published by Elsevier.

Atrial fibrillation (AF) is the most common sustained arrhythmia treated in clinical practice and is associated with substantial morbidity. Indeed, the lifetime risk of developing AF in individuals older than 40 years is 1 in 4. The Canadian Cardiovascular Society (CCS) last published a set of recommendations on the diagnosis and management of AF in 2005.

Since then, major advances in the management of AF have occurred, including the results of clinical trials providing guidance on pharmacologic therapies for management of AF, antithrombotic therapies for prevention of systemic thromboembolism, the continuing evolution of catheter ablation for treatment of AF, and the development of a simple semiquantitative scale that closely approximates patient-reported subjective measures of quality of life in AF.

In 2009, the CCS convened a primary panel of experts to undertake a comprehensive review of current knowledge and management strategies in the field of AF and to develop an up-to-date evidence-based set of recommendations, easily available to primary care physicians, emergency room physicians, internists, and cardiologists, on the diagnosis and management of patients with AF. The guidelines are broadly applicable across a spectrum of practice environments. It is expected that optimized management of AF may improve quality of life and reduce rates of stroke and hospitalization for AF-related causes across all levels of care in a large population of patients.