EHJ

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

 Authors

1. Authors/Task Force Members:,
2. Paulus Kirchhof*, (Chairperson) (UK/Germany),
3. Stefano Benussi*,¹, (Co-Chairperson) (Switzerland),
4. Dipak Kotecha, (UK),
5. Anders Ahlsson¹, (Sweden),
6. Dan Atar, (Norway),
7. Barbara Casadei, (UK),
8. Manuel Castella¹, (Spain),
9. Hans-Christoph Diener², (Germany),
10. Hein Heidbuchel, (Belgium),
11. Jeroen Hendriks, (The Netherlands),
12. Gerhard Hindricks, (Germany),
13. Antonis S. Manolis, (Greece),
14. Jonas Oldgren, (Sweden),
15. Bogdan Alexandru Popescu, (Romania),
16. Ulrich Schotten, (The Netherlands),
17. Bart Van Putte¹, (The Netherlands) and
18. Panagiotis Vardas, (Greece)

1. *Corresponding authors: Paulus Kirchhof, Institute of Cardiovascular Sciences, University of Birmingham, SWBH and UHB NHS trusts, IBR, Room 136, Wolfson Drive, Birmingham B15 2TT, United Kingdom, Tel: [phone], E-mail: [e-mail]; Stefano Benussi, Department of Cardiovascular Surgery, University Hospital Zurich, R?mistrasse 100, 8091 Zürich, Switzerland, Tel: [phone], E-mail: [e-mail].

1. Document Reviewers:,
2. Stefan Agewall, (CPG Review Co-ordinator) (Norway),
3. John Camm, (CPG Review Co-ordinator) (UK),
4. Gonzalo Baron Esquivias, (Spain),
5. Werner Budts, (Belgium),
6. Scipione Carerj, (Italy),
7. Filip Casselman, (Belgium),
8. Antonio Coca, (Spain),
9. Raffaele De Caterina, (Italy),
10. Spiridon Deftereos, (Greece),
11. Dobromir Dobrev, (Germany),
12. José M. Ferro, (Portugal),
13. Gerasimos Filippatos, (Greece),
14. Donna Fitzsimons, (UK),
15. Bulent Gorenek, (Turkey),
16. Maxine Guenoun, (France),
17. Stefan H. Hohnloser, (Germany),
18. Philippe Kolh, (Belgium),
19. Gregory Y. H. Lip, (UK),
20. Athanasios Manolis, (Greece),
21. John McMurray, (UK),
22. Piotr Ponikowski, (Poland),
23. Raphael Rosenhek, (Austria),
24. Frank Ruschitzka, (Switzerland),
25. Irina Savelieva, (UK),
26. Sanjay Sharma, (UK),
27. Piotr Suwalski, (Poland),
28. Juan Luis Tamargo, (Spain),
29. Clare J. Taylor, (UK),
30. Isabelle C. Van Gelder, (The Netherlands),
31. Adriaan A. Voors, (The Netherlands),
32. Stephan Windecker, (Switzerland),
33. Jose Luis Zamorano, (Spain) and
34. Katja Zeppenfeld, (The Netherlands)

1. The disclosure forms of all experts involved in the development of these guidelines are available on the ESC website http://www./guidelines.

Key words

• Guidelines
• Atrial fibrillation
• Anticoagulation
• Vitamin K antagonists
• Non-vitamin K antagonist oral anticoagulants
• Left atrial appendage occlusion
• Rate control
• Cardioversion
• Rhythm control
• Antiarrhythmic drugs
• Upstream therapy
• Catheter ablation
• AF surgery
• Valve repair
• Pulmonary vein isolation
• Left atrial ablation

The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC)

Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC

Endorsed by the European Stroke Organisation (ESO)

Table of Contents

• 1 Preamble 10

• 2 Introduction 11

• 3 Epidemiology and impact for patients 12

• 3.1 Incidence and prevalence of atrial fibrillation 12

• 3.2 Morbidity, mortality, and healthcare burden of atrial fibrillation 12

• 3.3 Impact of evidence-based management on outcomes in atrial fibrillation patients 12

• 3.4 Gender 13

• 4 Pathophysiological and genetic aspects that guide management 14

• 4.1 Genetic predisposition 14

• 4.2 Mechanisms leading to atrial fibrillation 14

• 4.2.1 Remodelling of atrial structure and ion channel function 14

• 4.2.2 Electrophysiological mechanisms of atrial fibrillation 16

• 5 Diagnosis and timely detection of atrial fibrillation 17

• 5.1 Overt and silent atrial fibrillation 17

• 5.2 Screening for silent atrial fibrillation 17

• 5.2.1 Screening for atrial fibrillation by electrocardiogram in the community 17

• 5.2.2 Prolonged monitoring for paroxysmal atrial fibrillation 17

• 5.2.3 Patients with pacemakers and implanted devices 17

• 5.2.4 Detection of atrial fibrillation in stroke survivors 18

• 5.3 Electrocardiogram detection of atrial flutter 19

• 6 Classification of atrial fibrillation 19

• 6.1 Atrial fibrillation pattern 19

• 6.2 Atrial fibrillation types reflecting different causes of the arrhythmia 20

• 6.3 Symptom burden in atrial fibrillation 20

• 7 Detection and management of risk factors and concomitant cardiovascular diseases 21

• 7.1 Heart failure 22

• 7.1.1 Patients with atrial fibrillation and heart failure with reduced ejection fraction 23

• 7.1.2 Atrial fibrillation patients with heart failure with preserved ejection fraction 24

• 7.1.3 Atrial fibrillation patients with heart failure with mid-range ejection fraction 24

• 7.1.4 Prevention of atrial fibrillation in heart failure 25

• 7.2 Hypertension 25

• 7.2.1 Treatment of hypertension to prevent incident atrial fibrillation 25

• 7.2.2 Blood pressure control in patients …

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