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CLINICAL STATEMENTS AND GUIDELINES

Circulation. 2024;149:e1–e156. DOI: 10.1161/CIR.0000000000001193 January 2, 2024 e113

Joglar et al 2023 Guideline for the Diagnosis and Management of Atrial Fibrillation

Therapy for Atrial Fibrillation) will help determine whether they are suitable for clinical practice. Also, anticoagulation/DOAC use in pregnancy needs to be investigated because it is currently contraindicated in view of lack of data on safety. 14.	 Sleep: Among patients with AF and SDB, the impact of treatment of SDB on maintenance of sinus rhythm and on general cardiovascular outcomes remains uncertain. Most studies have been observational, which introduces confounding factors. Once diagnosed, the adherence to treatment for SDB is also suboptimal. 15.	 SDM and decision aids: Decision aids are perceived as important tools to better inform patients about options for AF management; yet, it is unclear if those tools improve clinical outcomes. Most decision aids developed for AF focus on anticoagulation; there is a paucity of validated decision aids, including for AF rhythm management using antiarrhythmic drugs or ablation. 16.	 Genetic testing: The use and applicability of consumer-based or targeted genetic testing for AF remains uncertain. Polygenic risk scores can indicate higher risk for AF, but the use of genetic testing to impact clinical surveillance, management, and clinical outcomes remains uncertain. 17.	 Race, ethnicity, gender, and sex differences: In sexual- and gender-diverse individuals, additional research is recommended to identify the incidence and outcomes of AF as well as the impact of gender-affirming therapies on arrhythmia incidence and outcomes. Additional data across racial and ethnic groups should also be encouraged. 18.	 Standardized measures: For patients with AF, a standardized measure might be useful to assess symptoms and/or QOL and impact of management strategies. 19.	 SDOH: The measurement and impact of SDOH in

AF is underutilized and understudied.

PEER REVIEW COMMITTEE MEMBERS

Andrew D. Krahn, MD, FHRS, Chair; Jason G. Andrade, MD, FHRS; Craig J. Beavers, PharmD, FACC, FAHA, FCCP, BCCP, BCPS (AQ-Cardiology), CACP; James M. Bischoff; T. Jared Bunch, MD, FACC, FHRS; Kristen Bova Campbell, PharmD, FACC; Lin Yee Chen, MD, MS, FAHA, FHRS; Robin Dharia, MD, FAHA; Michael P. Dorsch, PharmD, MS, FACC, FAHA; Edward P. Gerstenfeld, MD, MS, FACC, FHRS; Aubrey E. Jones, PharmD, MSCI; Stephanie Dwyer Kaluzna, PharmD; Luke Masha, MD, MPH; Isabelle Nault, MD; Peter A. Noseworthy, MD, FHRS; Cara N. Pellegrini, MD, FACC, FHRS; Stylianos E. Tzeis, MD; Annabelle Santos Volgman, MD, FACC, FAHA; Emily P. Zeitler, MD, MHS, FACC ACC/AHA JOINT COMMITTEE ON CLINICAL PRACTICE GUIDELINES

Joshua A. Beckman, MD, MS, FAHA, FACC, Chair; Catherine M. Otto, MD, FACC, FAHA, Chair-Elect; Anastasia L. Armbruster, PharmD, FACC; Leslie L. Davis, PhD, ANP-BC, FACC, FAHA; Lisa de las Fuentes, MD, MS, FAHA; Anita Deswal, MD, MPH, FACC, FAHA; Victor A. Ferrari, MD, FACC, FAHA; Adrian F. Hernandez, MD, FAHA; Heather M. Johnson, MD, MS, FAHA, FACC; W. Schuyler Jones, MD, FACC; Prateeti Khazanie, MD, MPH; Michelle M. Kittleson, MD, PhD, FACC; Debabrata Mukherjee, MD, FACC, FAHA; Latha Palaniappan, MD, MS, FAHA, FACC; Tanveer Rab, MD, FACC; Jacqueline E. Tamis-Holland, MD, FACC, FAHA; Y. Joseph Woo, MD, FACC, FAHA; Boback Ziaeian, MD, PhD, FAHA

PRESIDENTS AND STAFF

American College of Cardiology B. Hadley Wilson, MD, FACC, President Cathleen C. Gates, Chief Executive Officer Richard J. Kovacs, MD, MACC, Chief Medical Officer Mindy J. Saraco, MHA, Director, Clinical Policy and Guidelines Grace D. Ronan, Senior Production and Operations Manager, Clinical Policy Publications Leah Patterson, Project Manager, Clinical Content

Development American Heart Association/American College of Cardiology Thomas S.D. Getchius, National Senior Director, Guidelines Abdul R. Abdullah, MD, Director, Guideline Science and

Methodology American Heart Association Joseph C. Wu, MD, PhD, FAHA, President Nancy Brown, Chief Executive Officer Mariell Jessup, MD, FAHA, Chief Science and Medical Officer Nicole Aiello Sapio, EdD, Executive Vice President, Office of Science Strategies and Operations Radhika Rajgopal Singh, PhD, Senior Vice President, Office of Science and Medicine Prashant Nedungadi, BPharm, PhD, Vice President, Science and Medicine, Clinical Guidelines Anne Leonard, MPH, BSN, RN, FAHA, National Senior Director, Science and Medicine Jody Hundley, Senior Production and Operations Man-

ager, Scientific Publications, Office of Science Operations

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