National heart foundation of australia and cardiac society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018

Brieger, D; Amerena, J; Attia, JR; Bajorek, B; Chan, KH; Connell, C; Freedman, B; Ferguson, C; Hall, T; Haqqani, HM; Hendriks, J; Hespe, CM; Hung, J; Kalman, JM; Sanders, P; Worthington, J; Yan, T; Zwar, NA

National heart foundation of australia and cardiac society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018

Brieger, D Amerena, J Attia, JR Bajorek, B

Chan, KH Connell, C Freedman, B

Ferguson, C

Hall, T Haqqani, HM Hendriks, J Hespe, CM Hung, J Kalman, JM Sanders, P Worthington, J Yan, T Zwar, NA

Permalink

Publication Type:: Journal Article
Citation:: Medical Journal of Australia, 2018, 209 (8), pp. 356 - 362
Issue Date:: 2018-01-01

Closed Access

	Filename	Description	Size
	10.5694mja18.00646 (1).pdf	Published Version	1.05 MB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Brieger, D	en_US
dc.contributor.author	Amerena, J	en_US
dc.contributor.author	Attia, JR	en_US
dc.contributor.author	Bajorek, B https://orcid.org/0000-0002-2532-7187	en_US
dc.contributor.author	Chan, KH	en_US
dc.contributor.author	Connell, C	en_US
dc.contributor.author	Freedman, B https://orcid.org/0000-0002-3809-2911	en_US
dc.contributor.author	Ferguson, C https://orcid.org/0000-0002-2417-2216	en_US
dc.contributor.author	Hall, T	en_US
dc.contributor.author	Haqqani, HM	en_US
dc.contributor.author	Hendriks, J	en_US
dc.contributor.author	Hespe, CM	en_US
dc.contributor.author	Hung, J	en_US
dc.contributor.author	Kalman, JM	en_US
dc.contributor.author	Sanders, P	en_US
dc.contributor.author	Worthington, J	en_US
dc.contributor.author	Yan, T	en_US
dc.contributor.author	Zwar, NA	en_US
dc.date.available	2018-10-12	en_US
dc.date.issued	2018-01-01	en_US
dc.identifier.citation	Medical Journal of Australia, 2018, 209 (8), pp. 356 - 362	en_US
dc.identifier.issn	0025-729X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/128319
dc.description.abstract	© 2018 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. Introduction: Atrial fibrillation (AF) is increasing in prevalence and is associated with significant morbidity and mortality. The optimal diagnostic and treatment strategies for AF are continually evolving and care for patients requires confidence in integrating these new developments into practice. These clinical practice guidelines will assist Australian practitioners in the diagnosis and management of adult patients with AF. Main recommendations: These guidelines provide advice on the standardised assessment and management of patients with atrial fibrillation regarding:� screening, prevention and diagnostic work-up; acute and chronic arrhythmia management with antiarrhythmic therapy and percutaneous and surgical ablative therapies; stroke prevention and optimal use of anticoagulants; and� integrated multidisciplinary care. Changes in management as a result of the guideline: Opportunistic screening in the clinic or community is recommended for patients over 65 years of age. The importance of deciding between a rate and rhythm control strategy at the time of diagnosis and periodically thereafter is highlighted. b-Blockers or non-dihydropyridine calcium channel antagonists remain the first line choice for acute and chronic rate control. Cardioversion remains first line choice for acute rhythm control when clinically indicated. Flecainide is preferable to amiodarone for acute and chronic rhythm control. Failure of rate or rhythm control should prompt consideration of percutaneous or surgical ablation. The sexless CHA2DS2-VA score is recommended to assess stroke risk, which standardises thresholds across men and women; anticoagulation is not recommended for a score of 0, and is recommended for a score of ≥ 2. If anticoagulation is indicated, non-vitamin K oral anticoagulants are recommended in preference to warfarin. An integrated care approach should be adopted, delivered by multidisciplinary teams, including patient education and the use of eHealth tools and resources where available. Regular monitoring and feedback of risk factor control, treatment adherence and persistence should occur.	en_US
dc.relation.ispartof	Medical Journal of Australia	en_US
dc.relation.isbasedon	10.5694/mja18.00646	en_US
dc.subject.classification	General & Internal Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Atrial Fibrillation	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	New Zealand	en_US
dc.title	National heart foundation of australia and cardiac society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018	en_US
dc.type	Journal Article
utslib.citation.volume	8	en_US
utslib.citation.volume	209	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	8	en_US
pubs.publication-status	Published	en_US
pubs.volume	209	en_US

Abstract:

© 2018 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. Introduction: Atrial fibrillation (AF) is increasing in prevalence and is associated with significant morbidity and mortality. The optimal diagnostic and treatment strategies for AF are continually evolving and care for patients requires confidence in integrating these new developments into practice. These clinical practice guidelines will assist Australian practitioners in the diagnosis and management of adult patients with AF. Main recommendations: These guidelines provide advice on the standardised assessment and management of patients with atrial fibrillation regarding:� screening, prevention and diagnostic work-up; acute and chronic arrhythmia management with antiarrhythmic therapy and percutaneous and surgical ablative therapies; stroke prevention and optimal use of anticoagulants; and� integrated multidisciplinary care. Changes in management as a result of the guideline: Opportunistic screening in the clinic or community is recommended for patients over 65 years of age. The importance of deciding between a rate and rhythm control strategy at the time of diagnosis and periodically thereafter is highlighted. b-Blockers or non-dihydropyridine calcium channel antagonists remain the first line choice for acute and chronic rate control. Cardioversion remains first line choice for acute rhythm control when clinically indicated. Flecainide is preferable to amiodarone for acute and chronic rhythm control. Failure of rate or rhythm control should prompt consideration of percutaneous or surgical ablation. The sexless CHA2DS2-VA score is recommended to assess stroke risk, which standardises thresholds across men and women; anticoagulation is not recommended for a score of 0, and is recommended for a score of ≥ 2. If anticoagulation is indicated, non-vitamin K oral anticoagulants are recommended in preference to warfarin. An integrated care approach should be adopted, delivered by multidisciplinary teams, including patient education and the use of eHealth tools and resources where available. Regular monitoring and feedback of risk factor control, treatment adherence and persistence should occur.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/128319