ESC Clinical Practice Guidelines for the Management of Atrial Fibrillation – What You Need to Know
The European Society of Cardiology releases clinical practice guidelines every four years on diagnosing and treating patients with suspected atrial fibrillation (Afib). These were written by healthcare professionals and scientists. New is, that the latest guidelines were composed in consultation with two patient representatives. They also released for the first time a version of these guidelines specifically for patients with all the information that patients with Afib should know.
Wish to read the patient guideline report? Check it out here.
Key Concepts
Here are the key concepts of this article:
- The guidelines encourage patient participation, aiming to empower individuals with the knowledge to discuss treatment options confidently and manage risk factors to prevent complications.
- A key feature is the “CARE” model, focusing on managing comorbidities, preventing stroke, controlling heart rhythm, and ensuring continuous reassessment of patient care.
- Blood thinners are recommended for reducing stroke risk, with emphasis on proper medication use and lifestyle adjustments like managing blood pressure and reducing alcohol.
- The guidelines promote shared, equal, and educational care, ensuring that all patients receive the best treatment regardless of personal factors, and that they are involved in care decisions.
How do these guidelines help Afib patients?
These guidelines place patients at the center of care and encourage shared decision-making between healthcare professionals and patients. The document is intended to answer questions that patients may have and support them in conversations with their physicians. The guidelines will hopefully give patients the knowledge and confidence needed when discussing different treatment options and when seeking review or advice. Contributing to your own health care and managing risk factors is key to avoiding complications that may arise from Afib.
The patient guidelines report is also in general a very useful tool for those who have recently been diagnosed with atrial fibrillation and for individuals who wish to learn more about the arrhythmia and topics related to it. This article will delve into some of the interesting topics mentioned.
The “CARE” model for the management of Afib
The report features a model called “CARE” for the management of Afib that mentions all the main factors that can play a role in the severity and prevention of arrhythmia. Let’s break down the model:
C – Comorbidity and risk factor management
This part of the model aims to address other health conditions that cause and worsen Afib, or negatively affect the success of treatments. Here are conditions that you can help to reduce to improve your Afib outcomes:
- Treat high blood pressure (aim for less than 130/80)
- Use medication to control heart failure if needed,
- Partake in regular exercise (each day and build up gradually)
- Strive for better blood sugar control in diabetes
- Lower intake of alcohol (3 or less drinks per week)
- Consider weight loss if you are overweight (aim to lose 10% of body fat)
- General Health: healthy eating, lower cholesterol, stop smoking, manage other conditions.
A- Avoid stroke and thromboembolism
The second portion of the model aims to lower the chance of blood clots related to atrial fibrillation by implementing the use of blood thinners for those at risk. Common blood thinners include Apixaban, Dabigatran, Edoxaban, Rivaroxaban, and Warfarin.
The guideline recommends continuing blood thinners even if heart rhythm has returned to normal. This step also points out the importance of taking the medication at the right time and preventing bleeding with good blood pressure, less alcohol, and avoiding certain drugs.
R – Reduce symptoms by rate and rhythm control
The third portion of the model is all about the specific treatments to help manage Afib or switch to a normal heart rhythm. Here are some of the treatment options mentioned:
- Medications to restore normal heart rhythm
- Medications to keep you in a normal heart rhythm
- Electrical impulse to the heart (cardioversion)
- Ablation procedures through the veins
- Ablation procedure using keyhole surgery
- Ablation procedures during heart surgery
- Other treatments, such as a pacemaker
E – Evaluation and dynamic reassessment
The final point in the “CARE” model is placing importance on care that adapts to how your Afib can change over time to better prevent complications. Some excelled recommendations to consider including in your own treatment plan are:
- Investigations, such as an electrical tracing (ECG), blood tests, and a heart ultrasound scan
- Ongoing follow-up by healthcare staff in the hospital or with your community team
- Regular re-assessment of your risk factors for stroke or blood clots, and to prevent bleeding
- Support and advice for when to seek attention and to help you live a good life with your Afib
Shared care, equal care, and education
Three factors that can also majorly help patients, which were featured in the guidelines, are the importance of shared care, equal care, and education.
These being implemented ensures that you should expect to be involved in the decisions made, including what treatments you receive. Also, it means this process should involve a range of healthcare staff such as nurses, pharmacists, and specialist doctors, led by your general practitioner or cardiologist. Regardless of your race, gender, sexuality, culture, social factors, or disability, all patients will receive the best care possible. During the process of consultations, diagnosis, and treatments you and other patients should also receive information and education about atrial fibrillation, the treatments you may receive, and the possible benefits and side effects.
Education is vital for patients to be able to make informed decisions about their own care.
Read the full report on clinical practice guidelines here.
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