How the ESC 2012 guidelines on AF change clinical practice

The 2012 ESC Guidelines is a standalone publication which provides new recommendations which have the potential to change clinical practice. An update to the 2010 European Society of Cardiology guidelines for the management of atrial fibrillation, the 2012 ESC Guidelines take into account results of a number of clinical trials as well as increased experience from the wider use of novel oral anticoagulants. Perhaps the most important changes are the recommendations for opportunistic screening, the role of NOACs as broadly preferred over VKAs for the prevention of stroke and the acceptance of catheter ablation of AF as first line therapy.

Atrial fibrillation is the most common sustained cardiac arrhythmia. Left untreated atrial fibrillation is a significant risk factor for stroke and other morbidities. Atrial fibrillation management involves preventing complications, particularly stroke, and alleviating symptoms. Drug treatments used for atrial fibrillation management include anticoagulants to reduce the risk of stroke and antiarrhythmics to restore or maintain the normal heart rhythm or to slow the heart rate in people who remain in atrial fibrillation. Non‑pharmacological management includes electrical cardioversion, which may be used to 'shock' the heart back to its normal rhythm, and catheter or surgical ablation to create lesions to stop the abnormal electrical impulses that cause atrial fibrillation.

Current thinking about the management of AF will be on the agenda at the world’s largest cardiology meeting, ESC 2014 which takes place in Barcelona, Spain (30^th August to the 3^rd September). The aim of this cardiology meeting is to focus on innovations in science, clinical developments, implementation, education and in improving clinical practice. It will be a unique opportunity to bring together clinicians, scientists, epidemiologists, nurses, technicians, health care industry, care opinion leaders and policy makers.