2024 ESC Clinical Practice Guidelines for the Management of Atrial Fibrillation
With dedicated versions for healthcare professionals and patients.
02 Sep 2024
Banner-Guidelines_AFIB-Name-1500x1000.jpg Chairs of the Guidelines Task Force, Professor Isabelle C. Van Gelder (University of Groningen, University Medical Center Groningen - Groningen, Netherlands) and Professor Dipak Kotecha (University of Birmingham and University Hospitals Birmingham NHS Foundation Trust - Birmingham, UK), presented the new ESC Guidelines on atrial fibrillation (AF) to a packed auditorium.1
“Implementing patient-centred management to improve outcomes in those with AF is one of the main themes of the new guidelines,” explains Prof. Kotecha. “Past approaches have been evolved into the AF-CARE framework included in these guidelines, integrating the management of other health conditions as a critical part of improving and sustaining better patient wellbeing,” states Prof. Van Gelder.
Addressing [C] comorbidities and risk factors is the starting point of the AF-CARE framework due to growing evidence that therapies for AF are most effective, and recurrence least likely, when associated health conditions have been effectively managed. This is followed by considering how best to [A] avoid stroke and thromboembolism, which are often preventable in patients at risk by appropriate prescription of oral anticoagulants. [R] rate and rhythm control should be offered to all suitable patients with AF to reduce symptoms, and in some cases to improve prognosis. [E] evaluation and reassessment should be individualised for every patient, with a dynamic approach that accounts for how AF and its associated conditions change over time. The guidelines present the AF-CARE principles applied to patient pathways and across different clinical settings to improve implementation in routine practice.
Reflecting the current evidence base and improving implementation were key goals of the new guidelines, which were developed in parallel with learnings from the STEEER-AF trial,2 presented in Hot Line 6. The STEEER-AF trial – run by the ESC, European Heart Rhythm Association and the ESC Council on Stroke – aimed to improve implementation of guideline-adherent care. “The importance of a multidisciplinary approach to AF management cannot be overstated, and yet gaps in knowledge and skills are common among the broad array of healthcare professionals that treat patients with AF,” comments Prof. Van Gelder.
Patient education and empowerment are strongly advocated in the new guidelines, with an emphasis on shared decision-making to improve outcomes for individual patients. A patient version of the 2024 ESC Guidelines on AF is being released at the same time, summarising the important messages and where patients can be involved to improve their own outcomes. Prof. Kotecha notes: “Giving patients the confidence to be involved in conversations and decision-making about their care has the potential to transform management of AF, which remains a complex condition that can severely affect patient quality of life.”
The 2024 ESC Guidelines are now published in the European Heart Journal and the patient version is available on the dedicated webpage Guidelines for Patients.
References
- Van Gelder IC, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024. doi:10.1093/eurheartj/ehae176.
- Sterlinski M, et al. Europace. 2024;26:euae178.
