2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation.
The Canadian Cardiovascular Society (CCS) Atrial Fibrillation (AF) Guidelines Committee provides periodic reviews of new data to produce focused updates that address clinically important advances in AF management. This 2016 Focused Update deals with: (1) the management of antithrombotic therapy for AF patients in the context of the various clinical presentations of coronary artery disease; (2) real-life data with non-vitamin K antagonist oral anticoagulants; (3) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (4) digoxin as a rate control agent; (5) perioperative anticoagulation management; and (6) AF surgical therapy including the prevention and treatment of AF after cardiac surgery. The recommendations were developed with the same methodology used for the initial 2010 guidelines and the 2012 and 2014 Focused Updates. Using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) standards, individual studies and literature were reviewed for quality and bias; the literature review process and evidence tables are included in the Supplementary Material, and on the CCS Web site. The section on concomitant AF and coronary artery disease was developed in collaboration with the CCS Antiplatelet Guidelines Committee. Details of the updated recommendations are presented, along with their background and rationale. This document is linked to an updated summary of all CCS AF Guidelines recommendations, from 2010 to the present 2016 Focused Update.
Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada. Electronic address: lmacle@mac.com.
Laurent
L
Macle
University of British Columbia, Vancouver, British Columbia, Canada.
John
J
Cairns
University Health Network, University of Toronto, Toronto, Ontario, Canada.
Kori
K
Leblanc
University of British Columbia, Vancouver, British Columbia, Canada.
Teresa
T
Tsang
London Heart Institute, Western University, London, Ontario, Canada.
Allan
A
Skanes
QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Jafna L
JL
Cox
McMaster University and Hamilton General Hospital, Hamilton, Ontario, Canada.
Jeff S
JS
Healey
University of Toronto, Toronto, Ontario, Canada.
Alan
A
Bell
McGill University Health Centre, Montréal, Québec, Canada.
Louise
L
Pilote
Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
Jason G
JG
Andrade
Libin Cardiovascular Institute of Alberta, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada.
L Brent
LB
Mitchell
Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada.
Clare
C
Atzema
Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada.
David
D
Gladstone
McMaster University and Hamilton General Hospital, Hamilton, Ontario, Canada; The Canadian Stroke Network, Ottawa, Ontario, Canada.
Mike
M
Sharma
St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Subodh
S
Verma
McMaster University and Hamilton General Hospital, Hamilton, Ontario, Canada.
Stuart
S
Connolly
St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Paul
P
Dorian
QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Ratika
R
Parkash
Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
Mario
M
Talajic
Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
Stanley
S
Nattel
Southlake Regional Health Centre, Newmarket, Ontario, Canada.
Atul
A
Verma
D054058:Acute Coronary Syndrome / Q000628:therapy; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage / Q000601:surgery; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000009:adverse effects; D017115:Catheter Ablation; D003324:Coronary Artery Disease / Q000150:complications; D004077:Digoxin / Q000008:administration & dosage / Q000009:adverse effects; D004359:Drug Therapy, Combination; D065427:Factor Xa Inhibitors / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D000072657:ST Elevation Myocardial Infarction / Q000628:therapy; D020521:Stroke / Q000517:prevention & control
D000925:Anticoagulants; D002316:Cardiotonic Agents; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D004077:Digoxin; D008274:Magnesium