ESC guidelines on AF emphasize shared decision making

August 29, 2020 Duration: 2 minutes Source/Disclosure Source: Hindricks G and others. 2020 ESC Guidelines for Atrial Fibrillation. Presentation: European Heart Association; August 29-September 1, 2020 (virtual conference). Disclosure: Hindricks reported having had a financial relationship with Abbott, Biosense Webster, and Biotronik in 2018, but not since. Lip reports that he has financial ties with Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Janssen/Bayer, Pfizer and Verseon. Potpara reports that she has a financial relationship with Bayer and Pfizer. Add topics to email alerts Get an email when a new article is posted Enter your email address to receive an email when a new article is posted .. "data-action " subscribe "> Subscribe The request could not be processed. Please try again later. If you continue to experience this issue, please contact us customerservice@slackinc.com.. Return to Healio New Atrial Fibrillation Guidelines from the European Heart Association advocate cooperation between clinicians and patients as an option for AF treatment. Guidelines are presented at a virtual ESC conference, European Heart JournalRecommends better routes of care for anticoagulant therapy with'ABC', better symptom management, optimization of CV and comorbidities, and quantifies stroke and bleeding risk to help determine the best course of treatment4 Includes algorithms with one strategy. Source: Adobe Stock. "Patients want to be involved in decisions about their care And their preferences should be respected." Co-Chairs of the Guidelines Task Force Gerhard Hindricks, MD, The Department of Rhythm, Department of Rhythm, University of Leipzig, Germany, said in a press release. The guidelines “indicate a paradigm shift from a single-domain classification of atrial fibrillation to a comprehensive structured characterization of patients with atrial fibrillation, streamlining comprehensive risk assessment of AF patients and Co-Chairs of the Guideline Task Force on “Promoting Communication among Physicians of Different Physicians. Helping to Share Treatment Decisions” Tatjana Potpara, MD,PhD, During a virtual session on guidelines, an associate professor at the University of Belgrade Medical School in Serbia and a director of cardiologists and intensive arrhythmia care units at the Serbian Clinical Center in Belgrade said. The first pillar of the ABC pathway is avoiding stroke through anticoagulant, task force members Gregory YH Lip, MD, During the presentation, Chairman of Cardiovascular Medicine, Price Evans, and director of the Liverpool Cardiovascular Center at the University of Liverpool, said. He said: Low risk. "The first step is to identify low-risk patients CHA2DS2-VASc score If 0 in males or 1 in females, provide anticoagulant therapy to others after the risk of bleeding has been assessed. If possible, use the HAS-BLED score for evaluation. Oral anticoagulants, non-vitamin K antagonists are preferred, but he said that vitamin K antagonists may be considered if the time to therapeutic range is well managed. The second pillar is improved symptom control using "patient-centric rate and rhythm control decision making," Lip said. The third pillar is the optimization of comorbidities, including CV risk factors and lifestyle changes. The guidelines recommend the 4S-AF scheme to quantify the risk of AF patients. This scheme consists of four principles: Stroke risk assessed by CHA2DS2-VASc score; Severity of symptoms as assessed by the Quality of Life Questionnaire and the European Heart Rhythm Association Symptom Score; Severity of AF load, assessed by temporal pattern (seizure, persistence, long-term persistence or persistence) and total AF load (total time, longest episode, number of episodes for a particular period). And Incident AF risk score, AF progression risk score, biomarkers, echocardiography, CT, MRI, including data from diagnostic modalities such as CV risk factors, comorbidities, substrate severity assessed by diagnostic imaging results. The guidelines strongly support improving the lifestyle of patients diagnosed with AF, including regular physical activity, blood pressure control, and weight loss. This guideline was developed in collaboration with the European Cardiothoracic Surgery Association and the ESC European Heart Rhythm Association. reference: perspective Back to top Jonathan P. Piccini, MD, MHS, FACC, FAHA, FHRS Much emphasis has been placed on catheter ablation, and some of the data presented at the ESC further focuses on this discussion. The new ESC guidelines raise two important recommendations for catheter ablation. No. 1, they recommend ablation as a Class I recommendation for persistent AF that is symptomatic and refractory to antiarrhythmic therapy (American Heart Association/American Heart Association/Heart Rhythm Society Guidelines recommend Class IIA recommendations) I will provide counseling). No. 2, they assign the IIA recommendation for ablation in HF with reduced ejection fraction to improve survival and reduce HF hospitalization. The AHA/ACC/HRS guidelines only provide IIB recommendations for this display. This is a noticeable difference.Almost all elements of the ESC guidelines are, at least to some extent, US practice. Many of them are not universal (such as when using patient-reported results), but they will now receive more attention and emphasis. New guidelines highlight the ABC (anticoagulation, better symptom management, CV and comorbid optimization) pathway for managing AF. All three of these core management principles are important and emphasized. Emphasizing these principles through this mnemonic helps promote education for doctors and patients and improve outcomes. It is also worth noting that there are new Class I recommendations that clearly state that ECG is required for the diagnosis of AF. Of course, this is similar to the blue sky and round Earth, but this is a really important recommendation. With the advent of screening tools and smartwatches that do not use ECG-based detection methods, it is crucial to ensure that the healthcare community relies on ECG records for reliable diagnosis. Jonathan P. Piccini, MD, MHS, FACC, FAHA, FHRS Cardiovascular today Editorial board Duke University Medical Center Duke Clinical Laboratory Disclosure: Piccini reportedly received research grants from Abbott, AHA, Bayer, Boston Scientific, Phillips, Abbott, Allagan, ARCA BioPharma, Biotronic, Boston Scientific, Libanova, Medtronic, Milestone, Myocardia. , Philips, Sanofi and consulting on the latest information. Add topics to email alerts Get an email when a new article is posted Enter your email address to receive an email when a new article is posted .. "data-action " subscribe "> Subscribe The request could not be processed. Please try again later. If you continue to experience this issue, please contact us customerservice@slackinc.com.. 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