Atrial Fibrillation Guidelines

CE / CME

Charting a Course for Success: Navigating New Guidelines in Atrial Fibrillation Management and Treatment

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurses: 1.00 Nursing contact hour

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: maximum of 1.00 AMA PRA Category 1 Credit

Released: June 26, 2024

Expiration: June 25, 2025

Christopher B. Granger
Christopher B. Granger, MD

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2023 ACC/AHA Guidelines for Treatment of Atrial Fibrillation: Pillars of Management

The 2023 American College of Cardiology (ACC)/American Heart Association (AHA)/American College of Clinical Pharmacy (ACCP)/Heart Rhythm Society (HRS) Guidelines for the treatment of atrial fibrillation is organized around three pillars for atrial fibrillation management.1  The first of these is the assessment for and treatment of stroke risk.

The second is to optimize all modifiable risk factors, some of which are listed at the bottom of the figure. These include heart failure, exercise, hypertension, diabetes, tobacco, obesity, ethanol ingestion, and sleep. Regarding risk factors, many patients will inquire about the risk of using coffee and alcohol. Even modest amounts of alcohol—even 1 drink per day—have been shown in randomized trials to increase the burden of atrial fibrillation, including recurrence of paroxysmal atrial fibrillation. Limiting or avoiding alcohol might improve the burden of atrial fibrillation. By contrast, caffeine, specifically coffee, seems to have no effect when investigated in large studies.

The third is symptom management, including reducing atrial fibrillation burden with rhythm control and rate control. A key update to these guidelines, which will be discussed further, is the increasing evidence and strength of recommendation for considering atrial fibrillation ablation and its role in symptom management.

Listen to this brief audio clip summarizing a key takeaway about the 2023 atrial fibrillation guidelines.