The American College of Cardiology (ACC) and the American Heart Association (AHA) are two of the leading medical organizations that have developed new recommendations for managing and preventing atrial fibrillation (AFib). The guideline was published Thursday in the Journal of the American College of Cardiology and Circulation.
The guidance encourages a focus on healthy lifestyle to prevent or lessen the burden of AFib. The standards also call for early and more aggressive efforts to control rhythm. These include upgraded recommendations for catheter ablation as first line therapy to prevent disease progression. The package includes updated guidance to manage heart rate and rhythm medications, use of anticoagulants, and when to temporarily pause or stop the therapies.
AFib is the most common type of heart rhythm disorder, affecting more than 6 million Americans. The number is expected to double by 2030. Without treatment, AFib can lead to or exacerbate heart failure. It also significantly raises a person’s risk of having a stroke.
The guideline includes a new way to classify AFib based on stages. This breakdown focuses on the need for therapy, screening and prevention interventions at various stages. In the past, AFib was classified based only on arrhythmia duration, which centered on specific therapeutic interventions as opposed to a more holistic and multidisciplinary management approach.
Also new; The popular AFib treatment catheter ablation received the highest recommendation for certain people including those who have heart failure with reduced ejection fraction. The minimally invasive surgery disables parts of heart tissue that cause irregular heart rhythms.
“The new guideline reinforces the urgent need to approach AFib as a complex cardiovascular condition that requires disease prevention, risk factor modification, as well as optimizing therapies and patients’ access to care and ongoing, long-term management,” Jose Joglar, MD, professor of cardiac electrophysiology at UT Southwestern Medical Center in Dallas and chair of the writing committee, said in a statement.
The recommendations have a clear focus on risk factor modification that includes factors such as physical activity, weight management and blood pressure control. The recommendations are prescriptive so doctors can give people specific goals and provide a road map for how they can take control of the disease.
“Many patients don’t know where to start when they are given advice about lifestyle modification, so we are very specific with our recommendations,” Joglar said. “For example, instead of saying ‘you need to exercise,’ which is largely unhelpful to patients, we recommend talking with patients about what types of physical activity works for them and how many minutes they should be active each day or each week.”
