title: 2014 focused update of the Canadian Cardiovascular Society Guidelines for the management of atrial fibrillation.
abstract: Atrial fibrillation (AF) is an extremely common clinical problem with an important population morbidity and mortality burden. The management of AF is complex and fraught with many uncertain and contentious issues, which are being addressed by extensive ongoing basic and clinical research. The Canadian Cardiovascular Society AF Guidelines Committee produced an extensive set of evidence-based AF management guidelines in 2010 and updated them in the areas of anticoagulation and rate/rhythm control in 2012. In late 2013, the committee judged that sufficient new information regarding AF management had become available since 2012 to warrant an update to the Canadian Cardiovascular Society AF Guidelines. After extensive evaluation of the new evidence, the committee has updated the guidelines for: (1) stroke prevention principles; (2) anticoagulation of AF patients with chronic kidney disease; (3) detection of AF in patients with stroke; (4) investigation and management of subclinical AF; (5) left atrial appendage closure in stroke prevention; (6) emergency department management of AF; (7) periprocedural anticoagulation management; and (8) rate and rhythm control including catheter ablation. This report presents the details of the updated recommendations, along with their background and rationale. In addition, a complete set of presently applicable recommendations, those that have been updated and those that remain in force from previous guideline versions, is provided in the Supplementary Material.
authors.affiliation: Southlake Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada. Electronic address: atul.verma@utoronto.ca.
authors.forename: Atul
authors.initials: A
authors.lastname: Verma
authors.affiliation: GLD Health Care Centre, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: John A
authors.initials: JA
authors.lastname: Cairns
authors.affiliation: Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: L Brent
authors.initials: LB
authors.lastname: Mitchell
authors.affiliation: Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Laurent
authors.initials: L
authors.lastname: Macle
authors.affiliation: Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Stiell
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Gladstone
authors.affiliation: University of Alberta Hospital, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Michael Sean
authors.initials: MS
authors.lastname: McMurtry
authors.affiliation: Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Stuart
authors.initials: S
authors.lastname: Connolly
authors.affiliation: QEII Health Sciences Centre, Dalhousie University, Hailfax, Nova Scotia, Canada.
authors.forename: Jafna L
authors.initials: JL
authors.lastname: Cox
authors.affiliation: St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
authors.affiliation: Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Noah
authors.initials: N
authors.lastname: Ivers
authors.affiliation: University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kori
authors.initials: K
authors.lastname: Leblanc
authors.affiliation: Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Stanley
authors.initials: S
authors.lastname: Nattel
authors.affiliation: Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Healey
mesh_terms: D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D000991:Antithrombins / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000628:therapy*; D001562:Benzimidazoles / Q000008:administration & dosage; D002170:Canada; D000077144:Clopidogrel; D015897:Comorbidity; D000069604:Dabigatran; D004554:Electric Countershock; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D018570:Risk Assessment; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D000077144:Clopidogrel; D000069604:Dabigatran; D013988:Ticlopidine; D001241:Aspirin