p.3 抽出テキスト

Table of contents

1. Preamble .............................................................................................................. 3319 2. Introduction ....................................................................................................... 3321 2.1. What is new ............................................................................................. 3322 3. Definitions and clinical impact .................................................................... 3326 3.1. Definition and classification of AF ................................................... 3326 3.2. Diagnostic criteria for AF ................................................................... 3327 3.3. Symptoms attributable to AF ........................................................... 3328 3.4. Diagnostic evaluation of new AF ..................................................... 3328 3.5. Adverse events associated with AF ................................................ 3329 3.6. Atrial flutter .............................................................................................. 3330 4. Patient pathways and management of AF ............................................. 3330 4.1. Patient-centred, multidisciplinary AF management ................. 3330 4.1.1. The patient at the heart of care .............................................. 3330 4.1.2. Education and shared decision-making ................................. 3331 4.1.3. Education of healthcare professionals ................................... 3332 4.1.4. Inclusive management of AF ...................................................... 3332 4.2. Principles of AF-CARE ......................................................................... 3332 5. [C] Comorbidity and risk factor management ................................... 3338 5.1. Hypertension ............................................................................................ 3339 5.2. Heart failure .............................................................................................. 3339 5.3. Type 2 diabetes mellitus ...................................................................... 3340 5.4. Obesity ....................................................................................................... 3340 5.5. Obstructive sleep apnoea ................................................................... 3340 5.6. Physical inactivity .................................................................................... 3340 5.7. Alcohol excess ......................................................................................... 3341 6. [A] Avoid stroke and thromboembolism .............................................. 3341 6.1. Initiating oral anticoagulation ............................................................. 3341 6.1.1. Decision support for anticoagulation in AF ........................ 3341 6.2. Oral anticoagulants ................................................................................ 3343 6.2.1. Direct oral anticoagulants ........................................................... 3344 6.2.2. Vitamin K antagonists ................................................................... 3345 6.2.3. Clinical vs. device-detected subclinical AF ........................... 3345 6.3. Antiplatelet drugs and combinations with anticoagulants .... 3346 6.4. Residual ischaemic stroke risk despite anticoagulation .......... 3346 6.5. Percutaneous left atrial appendage occlusion ............................ 3346 6.6. Surgical left atrial appendage occlusion ........................................ 3347 6.7. Bleeding risk .............................................................................................. 3348 6.7.1. Assessment of bleeding risk ....................................................... 3348 6.7.2. Management of bleeding on anticoagulant therapy ......... 3348 7. [R] Reduce symptoms by rate and rhythm control ......................... 3351 7.1. Management of heart rate in patients with AF ......................... 3351 7.1.1. Indications and target heart rate .............................................. 3352 7.1.2. Heart rate control in the acute setting ................................. 3352 7.1.3. Long-term heart rate control .................................................... 3352 7.1.4. Atrioventricular node ablation and pacemaker implantation ................................................................................................... 3353 7.2. Rhythm control strategies in patients with AF .......................... 3353 7.2.1. General principles and anticoagulation ................................. 3353 7.2.2. Electrical cardioversion ................................................................ 3356 7.2.3. Pharmacological cardioversion .................................................. 3356 7.2.4. Antiarrhythmic drugs .................................................................... 3357 7.2.5. Catheter ablation ............................................................................ 3358 7.2.6. Anticoagulation in patients undergoing catheter ablation 3359 7.2.7. Endoscopic and hybrid AF ablation ........................................ 3360 7.2.8. AF ablation during cardiac surgery .......................................... 3361 7.2.9. Atrial tachycardia after pulmonary vein isolation ............. 3361 8. [E] Evaluation and dynamic reassessment ............................................. 3361 8.1. Implementation of dynamic care ..................................................... 3362 8.2. Improving treatment adherence ...................................................... 3362 8.3. Cardiac imaging ....................................................................................... 3362 8.4. Patient-reported outcome measures ............................................ 3363 9. The AF-CARE pathway in specific clinical settings ............................ 3364 9.1. AF-CARE in unstable patients .......................................................... 3364 9.2. AF-CARE in acute and chronic coronary syndromes ............ 3364 9.3. AF-CARE in vascular disease ............................................................. 3366 9.4. AF-CARE in acute stroke or intracranial haemorrhage ........ 3366 9.4.1. Management of acute ischaemic stroke ................................ 3366 9.4.2. Introduction or re-introduction of anticoagulation after ischaemic stroke .......................................................................................... 3367 9.4.3. Introduction or re-introduction of anticoagulation after haemorrhagic stroke .................................................................................. 3367 9.5. AF-CARE for trigger-induced AF .................................................... 3367 9.6. AF-CARE in post-operative patients ............................................. 3368 9.7. AF-CARE in embolic stroke of unknown source ..................... 3368 9.8. AF-CARE during pregnancy ............................................................... 3369 9.9. AF-CARE in congenital heart disease ............................................ 3370 9.10. AF-CARE in endocrine disorders ................................................. 3370 9.11. AF-CARE in inherited cardiomyopathies and primary arrhythmia syndromes .................................................................................. 3370 9.12. AF-CARE in cancer ............................................................................. 3371 9.13. AF-CARE in older, multimorbid, or frail patients .................. 3371 9.14. AF-CARE in atrial flutter .................................................................. 3371 10. Screening and prevention of AF ............................................................. 3371 10.1. Epidemiology of AF ............................................................................. 3371 10.2. Screening tools for AF ....................................................................... 3372 10.3. Screening strategies for AF .............................................................. 3373 10.3.1. Single timepoint screening ‘snapshot’ .................................. 3374 10.3.2. Prolonged screening ................................................................... 3374 10.4. Factors associated with incident AF ............................................ 3375 10.5. Primary prevention of AF ................................................................ 3375 10.5.1. Hypertension ................................................................................. 3376 10.5.2. Heart failure ................................................................................... 3376 10.5.3. Type 2 diabetes mellitus ........................................................... 3376 10.5.4. Obesity ............................................................................................. 3376 10.5.5. Sleep apnoea syndrome ............................................................ 3376 10.5.6. Physical activity .............................................................................. 3376 10.5.7. Alcohol intake ................................................................................ 3377 11. Key messages .................................................................................................. 3377 12. Gaps in evidence ............................................................................................ 3377 13. ‘What to do’ and ‘What not to do’ messages from the guidelines .................................................................................................................. 3379 14. Evidence tables ............................................................................................... 3382 15. Data availability statement ......................................................................... 3382 16. Author information ...................................................................................... 3382 17. Appendix ........................................................................................................... 3383 18. References ........................................................................................................ 3384 Downloaded from academic.oup.com/eurheartj/article/45/36/3314/7738779 by guest on 07 October 2026