Atrial fibrillation primary prevention: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(6 intermediate revisions by 2 users not shown)
Line 5: Line 5:
|}
|}
{{Atrial fibrillation}}
{{Atrial fibrillation}}
{{CMG}}; {{AE}} {{Anahita}} {{CZ}}  
{{CMG}}; {{AE}} {{Anahita}} {{CZ}} {{Laith}}
==Overview==
==Overview==
Although no certain [[Prevention (medical)|primary prevention]] has been introduced for [[atrial fibrillation]] ([[AF]]), some [[medications]] may prevent the [[atrial fibrillation]] development in specific [[patients]]. [[Amiodarone]], a [[beta blocker]], or a [[Calcium-channel blocker]] may be helpful to prevent [[atrial fibrillation]] in [[patients]] who undergone [[heart|cardiac]] [[surgery]]. Moreover, [[treatment]] with [[ACE inhibitor]] or [[ARB]] may lower the chance of [[atrial fibrillation]] development in [[hypertension|hypertensive]] [[patients]].


==Atrial Fibrillation Primary Prevention==
==Atrial Fibrillation Primary Prevention==
===Preventing Postoperative Atrial Fibrillation ===
===Preventing Postoperative Atrial Fibrillation ===
*Offer on of the following in order to prevent [[atrial fibrillation]] development in [[patients]] who have been undergone [[heart|cardiac]] [[surgery]]:<ref name="pmid34020968">{{cite journal| author=Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee| title=Atrial fibrillation: diagnosis and management-summary of NICE guidance. | journal=BMJ | year= 2021 | volume= 373 | issue=  | pages= n1150 | pmid=34020968 | doi=10.1136/bmj.n1150 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34020968  }} </ref>
*One of the following could be offered to [[Prevention (medical)|prevent]] [[atrial fibrillation]] development in [[patients]] who have been undergone [[heart|cardiac]] [[surgery]]:<ref name="pmid34020968">{{cite journal| author=Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee| title=Atrial fibrillation: diagnosis and management-summary of NICE guidance. | journal=BMJ | year= 2021 | volume= 373 | issue=  | pages= n1150 | pmid=34020968 | doi=10.1136/bmj.n1150 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34020968  }} </ref>
**[[Amiodarone]]
**[[Amiodarone]]
**[[Beta blocker]] (a standard [[beta blocker]] is suggested)
**[[Beta blocker]] (a standard [[beta blocker]] is suggested)
**[[Calcium-channel blockers]] such as [[diltiazem]] or [[verapamil]]
**[[Calcium-channel blockers]] such as [[diltiazem]] or [[verapamil]]
*In [[patients]] who have been undergone [[heart|cardiac]] [[surgery]] and were on a [[beta blocker]] before the [[surgery]], continue the [[treatment]] in the absence of any [[complications]] (such as [[surgery|postoperative]] [[bradycardia]] or [[hypotension]]).
*In [[patients]] who have been undergone [[heart|cardiac]] [[surgery]] and were on a [[beta blocker]] before the [[surgery]], continuing the [[treatment]] in the absence of any [[complications]] (such as [[surgery|postoperative]] [[bradycardia]] or [[hypotension]]) is recommended.
*Avoid offering [[digoxin]] in [[patients]] who have been undergone [[heart|cardiac]] [[surgery]] in order to prevent [[atrial fibrillation]].<ref name="pmid34020968">{{cite journal| author=Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee| title=Atrial fibrillation: diagnosis and management-summary of NICE guidance. | journal=BMJ | year= 2021 | volume= 373 | issue=  | pages= n1150 | pmid=34020968 | doi=10.1136/bmj.n1150 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34020968  }} </ref>
*Offering [[digoxin]] in [[patients]] who have been undergone [[heart|cardiac]] [[surgery]] in order to prevent [[atrial fibrillation]] should be avoided.<ref name="pmid34020968">{{cite journal| author=Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee| title=Atrial fibrillation: diagnosis and management-summary of NICE guidance. | journal=BMJ | year= 2021 | volume= 373 | issue=  | pages= n1150 | pmid=34020968 | doi=10.1136/bmj.n1150 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34020968  }} </ref>
*Do not use [[statins]] for the purpose of [[atrial fibrillation]] [[Prevention (medical)|prevention]] in [[patients]] who have been undergone [[heart|cardiac]] [[surgery]]. Nevertheless continuing [[statins]] in [[patients]] who had been on [[statins]] before the [[surgery]] is recommended.<ref name="pmid34020968">{{cite journal| author=Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee| title=Atrial fibrillation: diagnosis and management-summary of NICE guidance. | journal=BMJ | year= 2021 | volume= 373 | issue=  | pages= n1150 | pmid=34020968 | doi=10.1136/bmj.n1150 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34020968  }} </ref>
*[[Treatment]] with [[ACE inhibitor]] or [[ARB]] may lower the chance of [[atrial fibrillation]] development in [[hypertension|hypertensive]] [[patients]].<ref name="JanuaryWann2014">{{cite journal|last1=January|first1=C. T.|last2=Wann|first2=L. S.|last3=Alpert|first3=J. S.|last4=Calkins|first4=H.|last5=Cleveland|first5=J. C.|last6=Cigarroa|first6=J. E.|last7=Conti|first7=J. B.|last8=Ellinor|first8=P. T.|last9=Ezekowitz|first9=M. D.|last10=Field|first10=M. E.|last11=Murray|first11=K. T.|last12=Sacco|first12=R. L.|last13=Stevenson|first13=W. G.|last14=Tchou|first14=P. J.|last15=Tracy|first15=C. M.|last16=Yancy|first16=C. W.|title=2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society|journal=Circulation|year=2014|issn=0009-7322|doi=10.1161/CIR.0000000000000041}}</ref>
 
== 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society<ref name="pmid30686041">{{cite journal| author=January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC | display-authors=etal| title=2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. | journal=Circulation | year= 2019 | volume= 140 | issue= 2 | pages= e125-e151 | pmid=30686041 | doi=10.1161/CIR.0000000000000665 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30686041  }}</ref> ==
 
=== Recommendation for Weight Loss in Patients with AF Referenced studies that support the new recommendation are summarized in Online Data Supplement 10 ===
{| class="wikitable" style="width: 80%;"
|-
| colspan="1" style="text-align:center; background:LightGreen" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen" |1.   For overweight and obese patients with AF, weight loss, combined with risk factor modification, is recommended.S7.13-1–S7.13-3NEW: New data demonstrate the beneficial effects of weight loss and risk factor modification on controlling AF''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])''
|}
 


==2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)<ref name="JanuaryWann2014">{{cite journal|last1=January|first1=C. T.|last2=Wann|first2=L. S.|last3=Alpert|first3=J. S.|last4=Calkins|first4=H.|last5=Cleveland|first5=J. C.|last6=Cigarroa|first6=J. E.|last7=Conti|first7=J. B.|last8=Ellinor|first8=P. T.|last9=Ezekowitz|first9=M. D.|last10=Field|first10=M. E.|last11=Murray|first11=K. T.|last12=Sacco|first12=R. L.|last13=Stevenson|first13=W. G.|last14=Tchou|first14=P. J.|last15=Tracy|first15=C. M.|last16=Yancy|first16=C. W.|title=2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society|journal=Circulation|year=2014|issn=0009-7322|doi=10.1161/CIR.0000000000000041}}</ref>==
==2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)<ref name="JanuaryWann2014">{{cite journal|last1=January|first1=C. T.|last2=Wann|first2=L. S.|last3=Alpert|first3=J. S.|last4=Calkins|first4=H.|last5=Cleveland|first5=J. C.|last6=Cigarroa|first6=J. E.|last7=Conti|first7=J. B.|last8=Ellinor|first8=P. T.|last9=Ezekowitz|first9=M. D.|last10=Field|first10=M. E.|last11=Murray|first11=K. T.|last12=Sacco|first12=R. L.|last13=Stevenson|first13=W. G.|last14=Tchou|first14=P. J.|last15=Tracy|first15=C. M.|last16=Yancy|first16=C. W.|title=2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society|journal=Circulation|year=2014|issn=0009-7322|doi=10.1161/CIR.0000000000000041}}</ref>==

Latest revision as of 03:26, 14 December 2022



Resident
Survival
Guide

Atrial Fibrillation Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Atrial Fibrillation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Special Groups

Postoperative AF
Acute Myocardial Infarction
Wolff-Parkinson-White Preexcitation Syndrome
Hypertrophic Cardiomyopathy
Hyperthyroidism
Pulmonary Diseases
Pregnancy
ACS and/or PCI or valve intervention
Heart failure

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples
A-Fib with LBBB

Chest X Ray

Echocardiography

Holter Monitoring and Exercise Stress Testing

Cardiac MRI

Treatment

Rate and Rhythm Control

Cardioversion

Overview
Electrical Cardioversion
Pharmacological Cardioversion

Anticoagulation

Overview
Warfarin
Converting from or to Warfarin
Converting from or to Parenteral Anticoagulants
Dabigatran

Maintenance of Sinus Rhythm

Surgery

Catheter Ablation
AV Nodal Ablation
Surgical Ablation
Cardiac Surgery

Specific Patient Groups

Primary Prevention

Secondary Prevention

Supportive Trial Data

Cost-Effectiveness of Therapy

Case Studies

Case #1

Atrial fibrillation primary prevention On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Atrial fibrillation primary prevention

CDC on Atrial fibrillation primary prevention

Atrial fibrillation primary prevention in the news

Blogs on Atrial fibrillation primary prevention

Directions to Hospitals Treating Atrial fibrillation primary prevention

Risk calculators and risk factors for Atrial fibrillation primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3] Laith Adnan Allaham, M.D.[4]

Overview

Although no certain primary prevention has been introduced for atrial fibrillation (AF), some medications may prevent the atrial fibrillation development in specific patients. Amiodarone, a beta blocker, or a Calcium-channel blocker may be helpful to prevent atrial fibrillation in patients who undergone cardiac surgery. Moreover, treatment with ACE inhibitor or ARB may lower the chance of atrial fibrillation development in hypertensive patients.

Atrial Fibrillation Primary Prevention

Preventing Postoperative Atrial Fibrillation

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society[3]

Recommendation for Weight Loss in Patients with AF Referenced studies that support the new recommendation are summarized in Online Data Supplement 10

Class I
1.   For overweight and obese patients with AF, weight loss, combined with risk factor modification, is recommended.S7.13-1–S7.13-3NEW: New data demonstrate the beneficial effects of weight loss and risk factor modification on controlling AF(Level of Evidence: B-R)


2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)[2]

Rhythm Control

Pharmacological Agents for Preventing AF and Maintaining Sinus Rhythm

Upstream Therapy
Class III: No Benefit
"1. Therapy with an ACE inhibitor, ARB, or statin is not beneficial for primary prevention of AF in patients without cardiovascular disease. (Level of Evidence: B)"
Class IIa
"1. An ACE inhibitor or angiotensin-receptor blocker (ARB) is reasonable for primary prevention of new-onset AF in patients with HF with reduced LVEF. (Level of Evidence: B)"
Class IIb
"1. Therapy with an ACE inhibitor or ARB may be considered for primary prevention of new-onset AF in the setting of hypertension. (Level of Evidence: B)"
"2. Statin therapy may be reasonable for primary prevention of new-onset AF after coronary artery surgery. (Level of Evidence: A)"

Sources

References

  1. 1.0 1.1 1.2 Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee (2021). "Atrial fibrillation: diagnosis and management-summary of NICE guidance". BMJ. 373: n1150. doi:10.1136/bmj.n1150. PMID 34020968 Check |pmid= value (help).
  2. 2.0 2.1 2.2 January, C. T.; Wann, L. S.; Alpert, J. S.; Calkins, H.; Cleveland, J. C.; Cigarroa, J. E.; Conti, J. B.; Ellinor, P. T.; Ezekowitz, M. D.; Field, M. E.; Murray, K. T.; Sacco, R. L.; Stevenson, W. G.; Tchou, P. J.; Tracy, C. M.; Yancy, C. W. (2014). "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society". Circulation. doi:10.1161/CIR.0000000000000041. ISSN 0009-7322.
  3. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC; et al. (2019). "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons". Circulation. 140 (2): e125–e151. doi:10.1161/CIR.0000000000000665. PMID 30686041.


Template:WikiDoc Sources CME Category::Cardiology