title: Recent Atrial Fibrillation Guidelines - Looking at Both Sides of the Atlantic.
abstract: The American College of Cardiology (ACC), the American Heart Association (AHA) and the European Society of Cardiology (ESC) reported joint guidelines on atrial fibrillation (AF) in 2001 and a revised version in 2006. In 2010 new guidelines on AF were published by the ESC, and in 2011 by the American College of Cardiology Foundation (ACCF)/AHA/Heart Rhythm Society (HRS) and by the Canadian Cardiac Society (CCS). Focused updates have also appeared more recently. We reviewed these three sets of AF guidelines and compared their rating systems and their recommendations regarding four major AF management aspects (i.e. long-term rate control strategy, long-term rhythm control strategy, oral anticoagulation and AF catheter ablation). Significant differences were found between guidelines in the quality of evidence or level of evidence and on the strength of recommendations. Use of new anticoagulants and of new antiarrhythmic drug therapy is also discussed in the light of recent trial results. Whether multiplication of guidelines and differences in recommendation impact their implementation in clinical practice, remains to be assessed.
authors.affiliation: Professor of Cardiology, Aix-Marseille Université, School of Medicine, Marseille, France.
authors.forename: Samuel
authors.initials: S
authors.lastname: Lévy
keywords: Atrial fibrillation guidelines; anticoagulants; atrial fibrillation; catheter ablation; dronedarone; stroke
references.citation: J Am Coll Cardiol. 2001 Oct;38(4):1231-66
references.pmid: 11583910
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):67-73
references.pmid: 21329864
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):7-13
references.pmid: 21329856
references.citation: BMJ. 2008 Apr 26;336(7650):924-6
references.pmid: 18436948
references.citation: Am J Med. 2011 Feb;124(2):111-4
references.pmid: 20887966
references.citation: J Cardiovasc Electrophysiol. 2010 Jun 1;21(6):597-605
references.pmid: 20384650
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):74-90
references.pmid: 21329865
references.citation: J Cardiovasc Electrophysiol. 2012 Feb;23(2):155-62
references.pmid: 21955174
references.citation: Eur Heart J. 1998 Sep;19(9):1294-320
references.pmid: 9792255
references.citation: J Interv Card Electrophysiol. 2012 Mar;33(2):171-257
references.pmid: 22382715
references.citation: Arch Intern Med. 1972 May;129(5):836
references.pmid: 5025908
references.citation: N Engl J Med. 2002 Dec 5;347(23):1834-40
references.pmid: 12466507
references.citation: Chest. 2012 Feb;141(2 Suppl):e531S-75S
references.pmid: 22315271
references.citation: Thromb Haemost. 2011 Dec;106(6):997-1011
references.pmid: 22048796
references.citation: Pacing Clin Electrophysiol. 2009 Aug;32(8):1063-72
references.pmid: 19659628
references.citation: Nat Clin Pract Cardiovasc Med. 2006 Apr;3(4):220-5
references.pmid: 16568131
references.citation: N Engl J Med. 2008 Jun 19;358(25):2678-87
references.pmid: 18565860
references.citation: Eur Heart J. 2003 Aug;24(16):1481-7
references.pmid: 12919771
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):31-7
references.pmid: 21329860
references.citation: J Am Coll Cardiol. 2012 Aug 28;60(9):861-7
references.pmid: 22858389
references.citation: Circ Arrhythm Electrophysiol. 2011 Aug;4(4):592-3
references.pmid: 21846890
references.citation: Chest. 2013 Jan;143(1):179-84
references.pmid: 22722228
references.citation: Circulation. 2011 Jan 4;123(1):104-23
references.pmid: 21173346
references.citation: Am Heart J. 2008 Sep;156(3):527.e1-9
references.pmid: 18760136
references.citation: Circulation. 1999 Jun 15;99(23):3028-35
references.pmid: 10368121
references.citation: N Engl J Med. 2009 Feb 12;360(7):668-78
references.pmid: 19213680
references.citation: Circ Arrhythm Electrophysiol. 2009 Dec;2(6):599-602
references.pmid: 20009073
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):47-59
references.pmid: 21329862
references.citation: Can J Cardiol. 2012 Mar-Apr;28(2):125-36
references.pmid: 22433576
references.citation: N Engl J Med. 2009 Sep 17;361(12):1139-51
references.pmid: 19717844
references.citation: Circulation. 2011 Mar 15;123(10):e269-367
references.pmid: 21382897
references.citation: Eur Heart J. 2010 Oct;31(19):2369-429
references.pmid: 20802247
references.citation: J Am Coll Cardiol. 2006 Aug 15;48(4):854-906
references.pmid: 16904574
references.citation: Lancet. 2007 Aug 11;370(9586):493-503
references.pmid: 17693178
references.citation: J Am Coll Cardiol. 2004 Apr 7;43(7):1201-8
references.pmid: 15063430
references.citation: N Engl J Med. 2002 Dec 5;347(23):1825-33
references.pmid: 12466506
references.citation: Eur Heart J. 2012 Nov;33(21):2719-47
references.pmid: 22922413
references.citation: N Engl J Med. 2007 Sep 6;357(10):987-99
references.pmid: 17804843
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):27-30
references.pmid: 21329859
references.citation: Europace. 2010 Aug;12(8):1070-7
references.pmid: 20511358
references.citation: N Engl J Med. 2011 Sep 15;365(11):981-92
references.pmid: 21870978
references.citation: Age Ageing. 2007 Mar;36(2):151-6
references.pmid: 17175564
references.citation: N Engl J Med. 2011 Dec 15;365(24):2268-76
references.pmid: 22082198
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):60-6
references.pmid: 21329863
references.citation: Lancet. 2006 Jun 10;367 (9526):1903-12
references.pmid: 16765759
references.citation: Heart Rhythm. 2011 Mar;8(3):e1-8
references.pmid: 21324421
references.citation: N Engl J Med. 2011 Sep 8;365(10):883-91
references.pmid: 21830957
references.citation: J Interv Card Electrophysiol. 2009 Aug;25(2):111-6
references.pmid: 18975067
references.citation: N Engl J Med. 2010 Apr 15;362(15):1363-73
references.pmid: 20231232