Atrial fibrillation primary prevention: Difference between revisions

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{{CMG}}; {{AE}} {{CZ}}
{{CMG}}; {{AE}} {{CZ}}


==2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary (DO NOT EDIT)<ref name="JanuaryWann2014">{{cite journal|last1=January|first1=Craig T.|last2=Wann|first2=L. Samuel|last3=Alpert|first3=Joseph S.|last4=Calkins|first4=Hugh|last5=Cleveland|first5=Joseph C.|last6=Cigarroa|first6=Joaquin E.|last7=Conti|first7=Jamie B.|last8=Ellinor|first8=Patrick T.|last9=Ezekowitz|first9=Michael D.|last10=Field|first10=Michael E.|last11=Murray|first11=Katherine T.|last12=Sacco|first12=Ralph L.|last13=Stevenson|first13=William G.|last14=Tchou|first14=Patrick J.|last15=Tracy|first15=Cynthia M.|last16=Yancy|first16=Clyde W.|title=2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary|journal=Journal of the American College of Cardiology|year=2014|issn=07351097|doi=10.1016/j.jacc.2014.03.021}}</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>==


===Rhythm Control===
===Rhythm Control===


====Upstream Therapy: Recommendations====
====Upstream Therapy====


{|class="wikitable" style="width: 80%;"
{|class="wikitable" style="width: 80%;"
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|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III: No Benefit]]
|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.'''  Therapy with an ACE inhibitor, ARB, or statin is not beneficial for primary prevention of AF in patients without cardiovascular disease. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.'''  Therapy with an [[ACE inhibitor]], [[ARB]], or [[statin]] is not beneficial for primary prevention of [[AF]] in patients without cardiovascular disease. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
|}


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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''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. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' An [[ACE inhibitor]] or [[ARB|angiotensin-receptor blocker (ARB)]] is reasonable for primary prevention of new-onset [[AF]] in patients with [[HF]] with reduced [[LVEF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
|}


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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Therapy with an ACE inhibitor or ARB may be considered for primary prevention of new-onset AF in the setting of hypertension. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Therapy with an [[ACE inhibitor]] or [[ARB]] may be considered for primary prevention of new-onset [[AF]] in the setting of [[hypertension]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Statin therapy may be reasonable for primary prevention of new-onset AF after coronary artery surgery. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[Statin]] therapy may be reasonable for primary prevention of new-onset [[AF]] after [[coronary artery]] surgery. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|}
|}
==Sources==
==Sources==


* [https://content.onlinejacc.org/article.aspx?articleID=18542302014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary]<ref name="JanuaryWann2014">{{cite journal|last1=January|first1=Craig T.|last2=Wann|first2=L. Samuel|last3=Alpert|first3=Joseph S.|last4=Calkins|first4=Hugh|last5=Cleveland|first5=Joseph C.|last6=Cigarroa|first6=Joaquin E.|last7=Conti|first7=Jamie B.|last8=Ellinor|first8=Patrick T.|last9=Ezekowitz|first9=Michael D.|last10=Field|first10=Michael E.|last11=Murray|first11=Katherine T.|last12=Sacco|first12=Ralph L.|last13=Stevenson|first13=William G.|last14=Tchou|first14=Patrick J.|last15=Tracy|first15=Cynthia M.|last16=Yancy|first16=Clyde W.|title=2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary|journal=Journal of the American College of Cardiology|year=2014|issn=07351097|doi=10.1016/j.jacc.2014.03.021}}</ref>
* [http://circ.ahajournals.org/content/early/2014/03/27/CIR.0000000000000041 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation]<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>


==References==
==References==
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{{reflist|2}}
{{reflist|2}}


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{{Circulatory system pathology}}
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Revision as of 22:32, 31 March 2014



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: Cafer Zorkun, M.D., Ph.D. [2]

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)[1]

Rhythm Control

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 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.


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