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The Five Domains of Integrated AF Management
Atrial fibrillation (AF) is the most common heart rhythm disorder, with a steep rise predicted in the number of patients in coming years. The management of AF should include treatment of acute AF, cardiovascular risk reduction and treatment of comorbidities, stroke prevention using oral anticoagulation, heart rate control, and in selected symptomatic patients, the use of rhythm control therapy.
Click through to read more on the treatment options for AF management.
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Diagnosis & Screening
The diagnosis of AF requires an electrocardiogram (ECG) showing irregular RR intervals and no distinct P waves for at least 30 seconds.
ECG screening is useful in populations at risk of AF or those at high risk of stroke, including stroke survivors and older patients.
Looking for more information and useful tools for screening and diagnosing Atrial Fibrillation? Click through to learn more.
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Prevention & General Management
Evaluate AF-related symptoms using the modified European Heart Rhythm Association (EHRA) score.EHRA Class 2a and 2b can be differentiated by evaluating whether patients are functionally affected by their AF symptoms. AF-related symptoms are most commonly fatigue/tiredness and exertional shortness of breath, or less frequently palpitations and chest pain.
Refer your patients to the My Symptoms Score questionnaire (developed in line with the 2016 ESC Guidelines) on this website (General Public information) to evaluate their (EHRA) symptoms score. At the end of the questionnaire, a file with all entries and the related result can be downloaded allowing your patients to discuss them in more detail with you during their next appointment.
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Patient involvement
Providing tailored information and education to AF patients can empower them to support the management of their condition.Shared decision-making can ensure that care is based on the best available evidence and fits the needs, values, and preferences of the patient.
Refer your patients to the General Public information on this website: they will be able to find useful information, tools, downloadable materials and other AF patients’ stories.
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Stroke Prevention
One in four strokes are estimated to be caused by AF.The CHA2DS2-VASc score is recommended for stroke risk prevention in patients with AF.
Calculate and discuss your patients stroke risk by using the CHA2DS2-VASc score calculator on this website.
Summary ESC Guidelines, available for download
The European Society of Cardiology (ESC) developed and published updated guidelines for the management of Atrial Fibrillation in 2016. These were generated with contributions from the European Heart Rhythm Association (EHRA) of the ESC and are endorsed by the European Stroke Association.
The guidelines provide information and recommendations that cover all aspects of care required to identify, diagnose, effectively manage and educate patients with AF and any concomitant conditions.
They recommend the use of anticoagulants, cardioversion, rate control therapies and rhythm control therapies to manage AF. An integrated approach to AF management involving patients and a multidisciplinary team of healthcare professionals is discussed as best practice to improve access to care and support patient adherence.
Choice of rhythm control therapy after failure of initial rhythm control strategy requires patient involvement, consideration of patient preferences and informed decision-making.
Poster with 2016 ESC Guidelines Summary in 17 Key Points
Summary of the 2016 ESC Guidelines
2016 ESC Guidelines: Full Presentation
