|
|
Line 13: |
Line 13: |
|
| |
|
|
| |
|
| ==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>== | | == 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref> == |
|
| |
|
| ===Heart Failure and Atrial Fibrillation=== | | ===COMORBIDITIES IN PATIENTS WITH HF (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref> === |
| <SMALL>'''For WikiDoc page on Atrial Fibrillation click [[Atrial fibrillation|here]].'''</SMALL>
| |
| {|class="wikitable" | |
| |- | |
| | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Control of resting heart rate using either a beta blocker or nondihydropyridine calcium channel antagonist is recommended for patients with persistent or permanent AF and compensated HF with preserved ejection fraction ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
| |
| |- | |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' In the absence of pre-excitation, [[Intravenous therapy|intravenous]] [[beta-blocker]] administration (or a [[Calcium channel blocker|nondihydropyridine calcium channel antagonist]] in [[patients]] with [[Congestive heart failure|HFpEF]]) is recommended to slow the [[ventricle|ventricular]] response to [[atrial fibrillation]] in the acute setting, with caution needed in [[patients]] with overt [[congestion]], [[hypotension]], or [[heart failure]] with reduced [[left ventricle|left ventricular]] [[ejection fraction]]''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |
| |- | |
| |- | |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' In the absence of pre-excitation, [[intravenous therapy|intravenous]] [[digoxin]] or [[amiodarone]] is recommended to control [[heart rate]] acutely in [[patients]] with [[heart failure]]''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |
| |-
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.'''Assessment of [[heart rate]] control during [[Physical exercise|exercise]] and adjustment of [[pharmacology|pharmacological]] [[treatment]] to keep the [[heart rate|rate]] in the physiological range is useful in [[symptom|symptomatic]] [[patients]] during activity.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| |
| |-
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' [[Digoxin]] is effective to control resting [[heart rate]] in [[patients]] with [[heart failure]] with reduced [[ejection fraction]]''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
| |
| |-
| |
| |}
| |
|
| |
|
| {|class="wikitable"
| | ===Management of Comorbidities in Patients With HF (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref> === |
| |-
| |
| | colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
| |
| |-
| |
| | bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' [[AV nodal ablation|AV node ablation]] should not be performed without a [[pharmacology|pharmacological trial]] to achieve [[ventricle|ventricular]] rate control ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| |
| |- | |
| | bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' For [[heart rate|rate]] control, [[intravenous therapy|intravenous]] [[Calcium channel blocker|nondihydropyridine calcium channel antagonists]], [[intravenous therapy|intravenous]] [[beta blockers]], and [[dronedarone]] should not be administered to [[patients]] with decompensated [[heart failure]] ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |
| |-
| |
| |}
| |
|
| |
|
|
| |
| {|class="wikitable"
| |
| |-
| |
| | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' A combination of [[digoxin]] and a [[beta blocker]] (or a [[Calcium channel blocker|nondihydropyridine calcium channel antagonist]] for [[patients]] with [[Congestive heart failure|HFpEF]]) is reasonable to control resting and [[Physical exercise|exercise]] [[heart rate]] in [[patients]] with [[atrial fibrillation]] ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' It is reasonable to perform [[AV nodal ablation|AV node ablation]] with [[ventricle|ventricular]] pacing to control [[heart rate]] when [[pharmacology|pharmacological]] [[therapy]] is insufficient or not tolerated ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' [[intravenous therapy|Intravenous]] [[amiodarone]] can be useful to control [[heart rate]] in [[patients]] with [[atrial fibrillation]] when other measures are unsuccessful or [[contraindication|contraindicated]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' For [[patients]] with [[atrial fibrillation]] and rapid [[ventricle|ventricular]] response causing or suspected of causing [[tachycardia]]-induced [[cardiomyopathy]], it is reasonable to achieve [[heart rate|rate]] control by either [[AV nodalal ablation|AV nodal blockade]] or a rhythm-control strategy ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''5.''' For [[patients]] with [[Chronic (medical)|chronic]] [[heart rate]] who remain [[symptom|symptomatic]] from [[atrial fibrillation]] despite a rate-control strategy, it is reasonable to use a rhythm-control strategy''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| |
| |-
| |
| |}
| |
|
| |
| {|class="wikitable"
| |
| |-
| |
| | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[mouth|Oral]] [[amiodarone]] may be considered when resting and [[Physical exercise|exercise]] [[heart rate]] cannot be adequately controlled using a [[beta blocker]] (or a [[Calcium channel blocker|nondihydropyridine calcium channel antagonist]] in [[patients]] with [[Congestive heart failure|HFpEF]]) or [[digoxin]], alone or in combination ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[AV nodal ablation|AV node ablation]] may be considered when the [[heart rate|rate]] cannot be controlled and [[tachycardia]]-mediated [[cardiomyopathy]] is suspected ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| |
| |-
| |
| |}
| |
|
| |
| ==2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) <ref name="pmid16160202">Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16160202 ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society.] Circulation 112 (12):e154-235. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.167586 DOI:10.1161/CIRCULATIONAHA.105.167586] PMID: [http://pubmed.gov/16160202 16160202]</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] Circulation 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>==
| |
|
| |
| ===Patients who have Concomitant Disorders (DO NOT EDIT) <ref name="pmid16160202">Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16160202 ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society.] Circulation 112 (12):e154-235. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.167586 DOI:10.1161/CIRCULATIONAHA.105.167586] PMID: [http://pubmed.gov/16160202 16160202]</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] Circulation 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref> ===
| |
|
| |
| {|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"|<nowiki>"</nowiki>'''1.''' All other recommendations should apply to patients with concomitant disorders unless there are specific exceptions. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Physicians should control [[Systolic hypertension|systolic]] and diastolic [[hypertension]] and [[diabetes mellitus]] in patients with [[HF]] in accordance with recommended guidelines. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Physicians should use [[nitrates]] and [[beta-blockers]] for the treatment of [[angina]] in patients with [[HF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' Physicians should recommend [[coronary revascularization]] according to recommended guidelines in patients who have both [[HF]] and [[angina]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' Physicians should prescribe [[anticoagulants]] in patients with [[HF]] who have paroxysmal or persistent [[atrial fibrillation]] or a previous [[thromboembolic event]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''6.''' Physicians should control the ventricular response rate in patients with [[HF]] and [[atrial fibrillation]] with a [[beta-blocker]] (or [[amiodarone]], if the [[beta-blocker]] is contraindicated or not tolerated). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''7.''' Patients with [[coronary artery disease]] and [[HF]] should be treated in accordance with recommended guidelines for [[chronic stable angina]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''8.''' Physicians should prescribe [[antiplatelet agents]] for prevention of [[MI]] and death in patients with [[HF]] who have underlying [[coronary artery disease]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
| |
| |}
| |
|
| |
| {|class="wikitable" style="width:80%"
| |
| |-
| |
| | colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
| |
| |-
| |
| | bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Class I or III [[antiarrhythmic drugs]] are not recommended in patients with [[HF]] for the prevention of [[ventricular arrhythmias]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' Class Ia agents include [[quinidine]], [[procainamide]] and [[disopyramide]]. Class Ib agents include [[lidocaine]], [[mexiletine]], [[tocainide]], and [[phenytoin]]. Class Ic agents include [[encainide]], [[flecainide]], [[moricizine]], and [[propafenone]]. Class III agents include amiodarone, azimilide, bretylium, clofilium, dofetilide, tedisamil, ibutilide, sematilide, and sotalol. <nowiki>"</nowiki>
| |
|
| |
| |-
| |
| | bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' The use of [[antiarrhythmic medication]] is not indicated as primary treatment for asymptomatic [[ventricular arrhythmias]] or to improve survival in patients with [[HF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
| |
| |}
| |
|
| |
| {|class="wikitable" style="width:80%"
| |
| |-
| |
| | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to prescribe [[digitalis]] to control the ventricular response rate in patients with [[HF]] and [[atrial fibrillation]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' It is reasonable to treat patients with [[atrial fibrillation]] and [[HF]] with a strategy to maintain sinus rhythm or with a strategy to control ventricular rate alone. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' It is reasonable to prescribe [[amiodarone]] to decrease recurrence of [[atrial arrhythmias]] and to decrease recurrence of [[ICD]] discharge for [[ventricular arrhythmias]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| |
| |}
| |
|
| |
| {|class="wikitable" style="width:80%"
| |
| |-
| |
| | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' The usefulness of current strategies to restore and maintain [[sinus rhythm]] in patients with [[HF]] and [[atrial fibrillation]] is not well established. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' The usefulness of [[anticoagulation]] is not well established in patients with [[HF]] who do not have [[atrial fibrillation]] or a previous [[thromboembolic event]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
| |
| |-
| |
| | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' The benefit of enhancing [[erythropoiesis]] in patients with [[HF]] and [[anemia]] is not established. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| |
| |}
| |
|
| |
|
| ==Vote on and Suggest Revisions to the Current Guidelines== | | ==Vote on and Suggest Revisions to the Current Guidelines== |