The European Society of Cardiology presented New Afib Guidelines and Quality Indicators
New Afib Guidelines were presented at the ESC Digital Congress 2020
Updated September 7, 2020
- Summary: The European Society of Cardiology introduced new atrial fibrillation guidelines and quality indicators for the treatment of afib patients.
- Reading time: 2–3 minutes
At the 2020 European Society of Cardiology Congress: The Digital Experience, new afib guidelines were introduced.
These comprehensive new guidelines consist of 126 pages. A key message throughout is to consider patient values.
Some important takeaways include:
- The role of listening to the patient is central to these new guidelines
- NOACs (the new anticoagulants) are preferred over Vitamin K antagonists (warfarin)
- Screening for afib is essential and includes opportunistic screening for those 65+ and systematic screening for those 75+ (page 23)
- Catheter ablation is a first-line treatment for rhythm control in selected patients with symptomatic paroxysmal afib, or with persistent afib without major risk factors for recurrence (page 49)
Here are some new things that you may want to review in the guidelines:
- Section 2.1 (pages 9-13): What is new in the 2020 guidelines?
- Figure 5 (page 19): 4S-AF Scheme is used to characterize afib. There are four components:
- Stroke risk
- Symptom severity
- Severity of AF burden
- Substrate severity
- Section 9 (pages 26-29) talks about involving patients
- Section 10 (pages 29-59) talks about the ABC Pathway:
- A: Anticoagulation/Avoid stroke (including figure 12)
- B: Better symptom control (rate and rhythm control, including catheter ablation for rhythm control)
- C: Cardiovascular risk factors and concomitant diseases (co-morbidities and lifestyle interventions)
- Central Illustration for the Management of AF (page 79) — CC to ABC
- Confirm AF
- Characterize AF (the 4S-AF scheme)
- Treat AF: The ABC Pathway
- Section 18: Key messages (pages 77-78)
Additionally, a working group of the European Heart Rhythm Association produced new Quality Indicators for managing afib patient treatment. The new afib guidelines incorporated these quality indicators. Our founder, Mellanie True Hills, represented the afib patient community as a part of this working group.
The guidelines and quality indicators can be found below, along with a summary of key points in those guidelines from the American College of Cardiology.
- 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC
- Quality indicators for the care and outcomes of adults with atrial fibrillation
- Heart rhythm disorders are best managed when patients are listened to
- 2020 ESC Guidelines for Atrial Fibrillation: Key Points