Applying the atrial fibrillation guidelines update to manage your patients with atrial fibrillation

Abstract

Guidelines can be lengthy and complex to apply. We provide a concise summary of important components of outpatient atrial fibrillation management, based on the updated Canadian Cardiovascular Society guidelines. Common questions arising when caring for such patients are addressed, including: what underlying causes should be investigated and treated, how to assess and treat symptoms, how to determine and reduce stroke risk, and when to arrange subspecialty referral. The guidelines emphasize that emergency room visits are rarely necessary and quality of life for most patients with atrial fibrillation can be quite good. The guidelines also clarify that bleeding risk factors should be assessed to identify modifiable issues, rather than as a reason to permanently withhold oral anticoagulant therapy. There is an opportunity to substantially reduce the morbidity and health-system costs related to atrial fibrillation through patient education related to symptom management and adherence to appropriate stroke prevention therapy.