Key Recommendations Lenient rate control (<110 beats per minute resting) is recommended over strict rate control (<80 beats per minute resting) for patients who have atrial fibrillation. The risk of stroke and bleeding should be discussed with all patients considering anticoagulation.
Read moreIs anticoagulation needed for atrial flutter?
Most patients with atrial flutter should be considered for chronic anticoagulation in a manner similar to those with atrial fibrillation (AF). This recommendation is based not only on the fact atrial flutter carries a risk for systemic embolization but also that these patients usually have episodes of AF.
Read moreWhat is the first-line treatment for atrial fibrillation?
Beta-blockers and calcium channel blockers are first-line agents for rate control in AF. These drugs can be administered either intravenously or orally. They are effective at rest and with exertion. Intravenous diltiazem or metoprolol are commonly used for AF with a rapid ventricular response.
Read moreHow often should AFib be monitored?
Although most recommendations suggest an IRM monitoring strategy between two and four 24-hour IRM per year for the detection of AF recurrence, most statements simultaneously note that these strategies have a limited sensitivity and a significant proportion of patients with AF recurrence will not be detected.
Read moreWhat is considered new onset atrial fibrillation?
New-onset atrial fibrillation (AF) is a new or first detectable episode of a chaotic and irregular atrial arrhythmia . Prevalence increases progressively with age.
Read moreWhat duration of atrial fibrillation is significant?
Contemporary North American and European guidelines recommend that the clinical pattern of atrial fibrillation (AF) be classified based on episode duration and persistence, with AF defined as paroxysmal if episode duration is less than 7 days and persistent if the episode duration is 7 days or longer .
Read moreWhat are current recommendations for anticoagulants in the patient with new onset AFib?
For patients with AF or atrial flutter of 48 hours’ duration or longer, or when the duration of AF is unknown, anticoagulation with warfarin (INR 2.0 to 3.0), a factor Xa inhibitor, or direct thrombin inhibitor is recommended for at least 3 weeks before and at least 4 weeks after cardioversion.
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