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Practice Guideline
. 2024 Jan 2;149(1):e1-e156.
doi: 10.1161/CIR.0000000000001193. Epub 2023 Nov 30.

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

José A Joglar, Mina K Chung, Anastasia L Armbruster  1 , Emelia J Benjamin, Janice Y Chyou, Edmond M Cronin, Anita Deswal  1 , Lee L Eckhardt, Zachary D Goldberger, Rakesh Gopinathannair, Bulent Gorenek, Paul L Hess  2 , Mark Hlatky, Gail Hogan  3 , Chinwe Ibeh, Julia H Indik, Kazuhiko Kido  4 , Fred Kusumoto, Mark S Link, Kathleen T Linta  3 , Gregory M Marcus, Patrick M McCarthy, Nimesh Patel, Kristen K Patton, Marco V Perez, Jonathan P Piccini, Andrea M Russo  5 , Prashanthan Sanders, Megan M Streur, Kevin L Thomas, Sabrina Times  6 , James E Tisdale, Anne Marie Valente  7 , David R Van Wagoner; Peer Review Committee Members
Collaborators, Affiliations
Practice Guideline

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

José A Joglar et al. Circulation. .

Erratum in

Abstract

Aim: The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation.

Methods: A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate.

Structure: Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.

Keywords: AHA Scientific Statements; acute coronary syndrome; alcohol; anticoagulants; anticoagulation agents; antiplatelet agents; apixaban; atrial fibrillation; atrial flutter; cardioversion; catheter ablation; coronary artery disease; coronary heart disease; dabigatran; edoxaban; exercise; heart failure; hypertension; idarucizumab; left atrial appendage occlusion; myocardial infarction; obesity; percutaneous coronary intervention; pulmonary vein isolation; risk factors; rivaroxaban; sleep apnea; stents; stroke; surgical ablation; thromboembolism; warfarin.

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Figures

Figure 1.
Figure 1.. Temporal Trends in Counts and Age-Standardized Rates of AF-Prevalent Cases by Social Demographic Index Quintile for Both Sexes Combined, 1990–2017.
Trends in counts of AF-prevalent cases by SDI quintile, 1990–2017. SDI was made up of the geometric mean of 3 common indicators: the lag distributed income per capita, mean educational achievement for those aged ≥15 y, and total fertility rate <25 y. SDI ranged from 0 to 1, where 0 represents the theoretical minimum level of development, whereas 1 represents the theoretical maximum level of development. Modified from Dai et al by permission of Oxford University Press on behalf of the European Society of Cardiology. Copyright 2020 Oxford University Press. AF indicates atrial fibrillation; and SDI, Social Demographic Index.
Figure 2.
Figure 2.. Prevalence of AF Among Medicare Beneficiaries, 1993–2007.
(A) In the overall cohort, (B) by age group, (C) by sex, and (D) by race. The dashed lines in panel A represent 95% CIs. Reproduced with permission from Piccini et al. Copyright 2012 American Heart Association, Inc. AF indicates atrial fibrillation.
Figure 3.
Figure 3.. Age-Standardized Global Prevalence Rates of AF and Atrial Flutter per 100 000, Both Sexes, 2020.
During each annual GBD Study cycle, population health estimates are produced for the full-time series. Improvements in statistical and geospatial modeling methods and the addition of new data sources may lead to changes in past results across GBD Study cycles. Modified with permission from Tsao et al. Copyright 2023 American Heart Association, Inc. Source: Institute for Health Metrics Evaluation. Used with permission. All rights reserved. AF indicates atrial fibrillation; and GBD, Global Burden of Disease.
Figure 4.
Figure 4.. AF Stages: Evolution of Atrial Arrhythmia Progression.
*Heart failure, valve disease, coronary artery disease, hypertrophic cardiomyopathy, neuromuscular disorders, thyroid disease. Original figure created by the 2023 Atrial Fibrillation Guideline Writing Committee. AF indicates atrial fibrillation.
Figure 5.
Figure 5.. Pillars for AF Management.
AF indicates atrial fibrillation.
Figure 6.
Figure 6.. Types of Atrial Flutter and Macroreentrant Atrial Tachycardia.
The typical, reverse typical, and the lower-loop flutter all have the low right atrial isthmus incorporated in the flutter circuit. Other macroreentrant flutters include scar-mediated reentrant tachycardia and left mitral isthmus flutter. Modified with permission from Wellens et al. Copyright 2002 American Heart Association, Inc. Fl indicates flutter; LA, left atrium; and MRT, macroreentrent.
Figure 7.
Figure 7.. Mechanisms and Pathways Leading to AF.
The pathways that contribute to the development of AF create a substrate for reentry and provide triggers that can initiate arrhythmic activity. AF indicates atrial fibrillation; PAC, premature atrial contraction; NLRP3, NOD-, LRR- and pyrin domain-containing protein 3; and RAAS, renin-angiotensin-aldosterone system.
Figure 8.
Figure 8.. Contemporary Summary of the Role of the ANS in AF.
Original figure created by the 2023 Atrial Fibrillation Guideline Writing Committee. AF indicates atrial fibrillation; ANS, autonomic nervous system; HRV, heart rate variability; and LA, left atrium.
Figure 9.
Figure 9.. Rates of Stroke by Stroke Risk Score Levels in Different Cohorts.
Overall stroke rate in atrial fibrillation cohorts in order of descending stroke rate (events per 100 person-years). Reproduced with permission from Quinn et al. Copyright 2017 American Heart Association, Inc.
Figure 10.
Figure 10.. Antithrombotic Options in Patients With AF.
Colors correspond to Table 2. AF indicates atrial fibrillation; and DOAC, direct oral anticoagulant.
Figure 11.
Figure 11.. DOAC Laboratory Monitoring.
*HAS-BLED scoring (low risk=score 0, moderate risk=score 1–2, high risk=score ≥3): uncontrolled hypertension (systolic blood pressure >160 mm Hg)=1 point; abnormal renal (serum creatinine >2.26 mg/dL, dialysis, or kidney transplant) or hepatic function (bilirubin >2 times upper limit normal, alanine aminotransferase/aspartate aminotransferase/alkaline phosphatase >3 times upper limit normal, or cirrhosis)=1 or 2 points; stroke (hemorrhagic or ischemic)=1 point; bleeding history or predisposition=1 point; labile INR (time in therapeutic range <60%)=1 point; elderly age ≥65 years=1 point; drugs (antiplatelet agents or nonsteroidal anti-inflammatory drugs) or excessive alcohol intake (8 units/week)=1 or 2 points. †Child-Pugh scoring: the severity of liver disease, primarily cirrhosis in patients with documented liver disease. Child-Pugh A (mild): 5 to 6 points; Child-Pugh B (moderate): 7 to 9 points; Child-Pugh C (severe): 10 to 15 points. The score is based on the 5 variables: encephalopathy (none=1 point, grade 1 and 2=2 points, grade 3 and 4=3 points); ascites (none=1 point, slight=2 points, moderate=3 points); total bilirubin (<2 mg/mL=1 point, 2–3 mg/mL=2 points, >3 mg/mL=3 points); albumin (>3.5 mg/mL=1 point, 2.8–3.5 mg/mL=2 points, <2.8 mg/mL=3 points); INR (<1.7=1 point, 1.7–2.2=2 points, >2.2=3 points). Original figure created by the 2023 Atrial Fibrillation Guideline Writing Committee. CrCL indicates creatinine clearance based on actual body weight; DOAC, direct oral anticoagulant; and INR, international normalized ratio.
Figure 12.
Figure 12.. Consideration of Oral Anticoagulation for Device-Detected AHREs According to Patient Stroke Risk by CHA2DS2-VASc Score and Episode Duration.
A potential approach to patients with SCAF could consider both patient risk (as gauged by the CHA2DS2-VASc score) and SCAF burden/duration. Circle A indicates patients at low risk or with short and infrequent AHREs do not require anticoagulation; Circle B, patients with intermediate risk and AHREs lasting >6 min to 24 h are an uncertain population but are currently under study in 2 prospective randomized controlled trials; and Circle C, patients at high risk with longer episodes could be considered reasonable candidates for anticoagulation, although the precise threshold for SCAF duration remains uncertain. Reproduced with permission from Noseworthy et al. Copyright 2019 American Heart Association, Inc. Modified from Freedman et al. Copyright 2017 Springer Nature Limited. AF indicates atrial fibrillation; AHRE, atrial high-rate episode; ARTESiA, Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Subclinical Atrial Fibrillation trial; COMMANDER HF, A Study to Assess the Effectiveness and Safety of Rivaroxaban in Reducing the Risk of Death, Myocardial Infarction, or Stroke in Participants With Heart Failure and Coronary Artery Disease Following an Episode of Decompensated Heart Failure; COMPASS, Cardiovascular Outcomes for People Using Anticoagulation Strategies; ECG, electrocardiogram; NOAH, Non–Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial High Rate Episodes Trial; OAC, oral anticoagulation; and SCAF, subclinical atrial fibrillation. Female sex is treated as a modifier in the computation of the CHA2DS2-VASc score.
Figure 13.
Figure 13.. Active Bleeding Associated With Oral Anticoagulant.
Colors correspond to Table 2. PCC indicates prothrombin complex concentrate.
Figure 14.
Figure 14.. Forms of ICH, Classified by Mechanism.
ICH indicates intracranial hemorrhage.
Figure 15.
Figure 15.. Flowchart: Management of Periprocedural Anticoagulation in Patients With AF.
Colors correspond to Table 2. AF indicates atrial fibrillation; CHA2DS2-VASc, congestive heart failure, hypertension, age ≥75 y (doubled), diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism (doubled), vascular disease, age 65 to 74 y, sex category; DOAC, direct oral anticoagulant; ICD, implantable cardioverter-defibrillator; TE, thromboembolism; and TIA, transient ischemic attack.
Figure 16.
Figure 16.. Anticoagulation for Typical (CTI-Dependent) AFL
*Intraprocedural documentation of bidirectional block. †For example, left atrial enlargement, inducible AF, COPD, concomitant heart failure. Colors correspond to Table 2. AF indicates atrial fibrillation; AFL, atrial flutter; COPD, chronic obstructive pulmonary disease; and CTI, cavotricuspid isthmus.
Figure 17.
Figure 17.. Acute Rate Control in AF With RVR.
*Contraindicated in patients with moderate-severe LV dysfunction regardless of decompensated HF. Colors correspond to Table 2. AF indicates atrial fibrillation; AV, atrioventricular; HF, heart failure; LV, left ventricular; and RVR, rapid ventricular response.
Figure 18.
Figure 18.. AF Long-Term Rate Control.
Colors correspond to Table 2. AF indicates atrial fibrillation; LVEF, left ventricular ejection fraction; and NDCC, nondihydropyridine calcium channel blocker.
Figure 19.
Figure 19.. Patient and Clinical Considerations for Choosing Between Rhythm Control and Rate Control.
Patient and clinical considerations for deciding between rhythm- and rate-control strategies in a patient with a high burden of AF. AF indicates atrial fibrillation; AV, atrioventricular; LA, left atrium; and LV, left ventricular.
Figure 20.
Figure 20.. Flowchart for Treatment Choices When Required to Decrease AF Burden.
*Younger with few comorbidities. Colors correspond to Table 2. AF indicates atrial fibrillation.
Figure 21.
Figure 21.. Patients With Hemodynamically Stable AF Planned for Cardioversion.
Colors correspond to Table 2. AC indicates anticoagulation; AF, atrial fibrillation; and LAAO, left atrial appendage occlusion.
Figure 22.
Figure 22.. Treatment Algorithm for Pharmacological Conversion of AF to Sinus Rhythm.
*In the absence of preexcitation. †First dose administered in a facility that can provide continuous electrocardiographic monitoring and cardiac resuscitation because of the potential for proarrhythmia or postconversion bradycardia. ‡IV amiodarone requires several hours for efficacy; ibutilide is generally effective in 30 to 90 min but carries a higher risk of QT interval prolongation and torsades de pointes. §Recommend avoidance of IV procainamide for patients initially treated with amiodarone or ibutilide to avoid excessive QT interval prolongation and torsades de pointes. Rather, procainamide may be considered for patients for whom amiodarone and ibutilide are not considered optimal as first-line drugs. Colors correspond to Table 2. AF indicates atrial fibrillation; HFrEF, heart failure with reduced ejection fraction; IV, intravenous; LV, left ventricular; LVEF, left ventricular ejection fraction.
Figure 23.
Figure 23.. Treatment Algorithm for Drug Therapy for Maintenance of Sinus Rhythm.
In each box, drugs are listed in alphabetical order. Significant structural heart disease with scar or fibrosis. Colors correspond to Table 2. HFrEF indicates heart failure with reduced ejection fraction; HF, heart failure; IV, intravenous; LV, left ventricular; LVEF, left ventricular ejection fraction; MI, myocardial infarction; and NYHA FC, New York Heart Association functional class.
Figure 24.
Figure 24.. Management of Patients With HF and AF.
Colors correspond to Table 2. AF indicates atrial fibrillation; AV, atrioventricular; CMP, cardiomyopathy; CMR, cardiac magnetic resonance; GDMT, guideline-directed medical therapy; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; IV, intravenous; LVEF, left ventricular ejection fraction; NDCC, nondihydropyridine calcium channel blocker; and NYHA, New York Heart Association.
Figure 25.
Figure 25.. Prevention of AF After Cardiac Surgery.
Colors correspond to Table 2. AF indicates atrial fibrillation; and CABG, coronary artery bypass graft.
Figure 26.
Figure 26.. Treatment of AF After Cardiac Surgery.
Colors correspond to Table 2. AF indicates atrial fibrillation; and HR, heart rate.
Figure 27.
Figure 27.. Unadjusted Cumulative Risk of AF Recurrence.
Unadjusted curves displaying cumulative risk of recurrent AF, generated using Kaplan-Meier method. (A) Overall risk of recurrent AF among individuals with and without acute precipitants. (B) Overall risk of recurrent AF among individuals with infection, cardiac surgery, and noncardiothoracic surgery compared with no precipitant. These 3 precipitants were selected for display because the risk of recurrent AF was significantly lower compared with the referent group without precipitants in multivariable adjusted models. Individuals with other AF precipitants were excluded from this plot for clarity. Reproduced with permission from Wang et al. Copyright 2020 American Heart Association, Inc. AF indicates atrial fibrillation; and CT, cardiothoracic.
Figure 28.
Figure 28.. Acute Medical or Surgical Illness.
Adapted with permission from Chyou et al. Copyright 2023 American Heart Association, Inc. AF indicates atrial fibrillation.
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References

PREAMBLE

    1. Committee on Standards for Developing Trustworthy Clinical Practice Guidelines, Institute of Medicine (US). Clinical Practice Guidelines We Can Trust. National Academies Press; 2011.
    1. Committee on Standards for Systematic Reviews of Comparative Effectiveness Research, Institute of Medicine (US). Finding What Works in Healthcare: Standards for Systematic Reviews. National Academies Press; 2011. - PubMed
    1. Anderson JL, Heidenreich PA, Barnett PG, et al. ACC/AHA statement on cost/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. Circulation. 2014;129:2329–2345. - PubMed
    1. ACCF/AHA Task Force on Practice Guidelines. Methodology Manual and Policies From the ACCF/AHA Task Force on Practice Guidelines. American College of Cardiology and American Heart Association. 2010. Accessed September 23, 2019. https://www.acc.org/Guidelines/About-Guidelines-and-Clinical-Documents/M... and https://professional.heart.org/-/media/phd-files/guidelines-and-statemen....
    1. Halperin JL, Levine GN, Al-Khatib SM, et al. Further evolution of the ACC/AHA clinical practice guideline recommendation classification system: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2016;133:1426–1428. - PubMed

Scope of the Guideline

    1. January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019;140:e125–e151. - PubMed
    1. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2019;140:e125–e151. - PubMed
    1. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation Developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42:373–498. - PubMed
    1. Andrade JG, Aguilar M, Atzema C, et al. The 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society comprehensive guidelines for the management of atrial fibrillation. Can J Cardiol. 2020;36:1847–1948. - PubMed
    1. Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139:e698–e800. - PubMed

Epidemiology

    1. Schnabel RB, Yin X, Gona P, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. Lancet. 2015;386:154–162. - PMC - PubMed
    1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023;147:e93–e621. - PubMed
    1. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 study. Circulation. 2014;129:837–847. - PMC - PubMed
    1. Turakhia MP, Guo JD, Keshishian A, et al. Contemporary prevalence estimates of undiagnosed and diagnosed atrial fibrillation in the United States. Clin Cardiol. 2023;46:484–493. - PMC - PubMed
    1. Deshmukh A, Iglesias M, Khanna R, et al. Healthcare utilization and costs associated with a diagnosis of incident atrial fibrillation. Heart Rhythm O2. 2022;3:577–586. - PMC - PubMed

Prevalence, Incidence, Morbidity, and Mortality

    1. Colilla S, Crow A, Petkun W, et al. Estimates of current and future incidence and prevalence of atrial fibrillation in the US adult population. Am J Cardiol. 2013;112:1142–1147. - PubMed
    1. Mou L, Norby FL, Chen LY, et al. Lifetime risk of atrial fibrillation by race and socioeconomic status: ARIC study (Atherosclerosis Risk in Communities). Circ Arrhythm Electrophysiol. 2018;11:e006350. - PMC - PubMed
    1. Weng LC, Preis SR, Hulme OL, et al. Genetic predisposition, clinical risk factor burden, and lifetime risk of atrial fibrillation. Circulation. 2018;137:1027–1038. - PMC - PubMed
    1. Staerk L, Wang B, Preis SR, et al. Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study. BMJ. 2018;361:k1453. - PMC - PubMed
    1. Chao TF, Liu CJ, Tuan TC, et al. Lifetime risks, projected numbers, and adverse outcomes in Asian patients with atrial fibrillation: a report from the Taiwan Nationwide AF Cohort Study. Chest. 2018;153:453–466. - PubMed

Risk Factors and Associated Heart Disease

    1. Belbasis L, Mavrogiannis MC, Emfietzoglou M, et al. Environmental factors, serum biomarkers and risk of atrial fibrillation: an exposure-wide umbrella review of meta-analyses. Eur J Epidemiol. 2020;35:223–239. - PubMed
    1. Alonso A, Krijthe BP, Aspelund T, et al. Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium. J Am Heart Assoc. 2013;2:e000102. - PMC - PubMed
    1. Allan V, Honarbakhsh S, Casas JP, et al. Are cardiovascular risk factors also associated with the incidence of atrial fibrillation? A systematic review and field synopsis of 23 factors in 32 population-based cohorts of 20 million participants. Thromb Haemost. 2017;117:837–850. - PMC - PubMed
    1. Roberts JD, Vittinghoff E, Lu AT, et al. Epigenetic age and the risk of incident atrial fibrillation. Circulation. 2021;144:1899–1911. - PMC - PubMed
    1. Huxley RR, Lopez FL, Folsom AR, et al. Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2011;123:1501–1508. - PMC - PubMed

Associated Arrhythmias

    1. Saoudi N, Cosio F, Waldo A, et al. A classification of atrial flutter and regular atrial tachycardia according to electrophysiological mechanisms and anatomical bases; a statement from a Joint Expert Group from The Working Group of Arrhythmias of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 2001;22:1162–1182. - PubMed
    1. Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC guidelines for the management of patients with supraventricular tachycardia. Eur Heart J. 2020;41:655–720. - PubMed
    1. Wellens HJ. Contemporary management of atrial flutter. Circulation. 2002;106:649–652. - PubMed

Mechanisms and Pathophysiology

    1. Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339:659–666. - PubMed
    1. Allessie M, Ausma J, Schotten U. Electrical, contractile and structural remodeling during atrial fibrillation. Cardiovasc Res. 2002;54:230–246. - PubMed

Electrophysiological Mechanisms and Electrical Remodeling

    1. Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339:659–666. - PubMed
    1. Egorov YV, Rosenshtraukh LV, Glukhov AV. Arrhythmogenic Interaction Between Sympathetic Tone and Mechanical Stretch in Rat Pulmonary Vein Myocardium. Front Physiol. 2020;11:237. - PMC - PubMed
    1. Van Wagoner DR, Pond AL, Lamorgese M, et al. Atrial L-type Ca2+ currents and human atrial fibrillation. Circ Res. 1999;85:428–436. - PubMed
    1. Van Wagoner DR, Pond AL, McCarthy PM, et al. Outward K+ current densities and Kv15 expression are reduced in chronic human atrial fibrillation. Circ Res. 1997;80:772–781. - PubMed
    1. Voigt N, Trausch A, Knaut M, et al. Left-to-right atrial inward rectifier potassium current gradients in patients with paroxysmal versus chronic atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3:472–480. - PMC - PubMed

Triggers of AF

    1. Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339:659–666. - PubMed
    1. Dewland TA, Vittinghoff E, Mandyam MC, et al. Atrial ectopy as a predictor of incident atrial fibrillation: a cohort study. Ann Intern Med. 2013;159:721–728. - PMC - PubMed
    1. Heckbert SR, Jensen PN, Austin TR, et al. Associations of left atrial function and structure with supraventricular ectopy: the Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc. 2021;10:e018093. - PMC - PubMed
    1. Howell SJ, Dukes JW, Vittinghoff E, et al. Premature atrial contraction location and atrial fibrillation inducibility. Circ Arrhythm Electrophysiol. 2023;16:e011623. - PMC - PubMed
    1. Voigt N, Trausch A, Knaut M, et al. Left-to-right atrial inward rectifier potassium current gradients in patients with paroxysmal versus chronic atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3:472–480. - PMC - PubMed

Atrial Structural Abnormalities, Remodeling, and Atrial Myopathy

    1. Goette A, Kalman JM, Aguinaga L, et al. EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication. Heart Rhythm. 2017;14:e3–e40. - PMC - PubMed
    1. Rudolph V, Andrie RP, Rudolph TK, et al. Myeloperoxidase acts as a profibrotic mediator of atrial fibrillation. Nat Med. 2010;16:470–474. - PMC - PubMed
    1. Deroubaix E, Folliguet T, Rucker-Martin C, et al. Moderate and chronic hemodynamic overload of sheep atria induces reversible cellular electrophysiologic abnormalities and atrial vulnerability. J Am Coll Cardiol. 2004;44:1918–1926. - PubMed

Upstream Pathways

    1. Purohit A, Rokita AG, Guan X, et al. Oxidized Ca(2+)/calmodulin-dependent protein kinase II triggers atrial fibrillation. Circulation. 2013;128:1748–1757. - PMC - PubMed
    1. Mesubi OO, Rokita AG, Abrol N, et al. Oxidized CaMKII and O-GlcNAcylation cause increased atrial fibrillation in diabetic mice by distinct mechanisms. J Clin Invest. 2021;131:e95747. - PMC - PubMed
    1. Yan J, Zhao W, Thomson JK, et al. Stress signaling JNK2 crosstalk with CaMKII underlies enhanced atrial arrhythmogenesis. Circ Res. 2018;122:821–835. - PMC - PubMed
    1. Yan J, Bare DJ, DeSantiago J, et al. JNK2, a newly-identified SERCA2 enhancer, augments an arrhythmic [Ca(2+)]SR leak-load relationship. Circ Res. 2021;128:455–470. - PMC - PubMed
    1. Norlander AE, Madhur MS, Harrison DG. The immunology of hypertension. J Exp Med. 2018;215:21–33. - PMC - PubMed

Role of the Autonomic Nervous System

    1. Chen PS, Chen LS, Fishbein MC, et al. Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy. Circ Res. 2014;114:1500–1515. - PMC - PubMed
    1. Linz D, Elliott AD, Hohl M, et al. Role of autonomic nervous system in atrial fibrillation. Int J Cardiol. 2019;287:181–188. - PubMed
    1. Malik V, Mishima R, A DE, et al. The “road” to atrial fibrillation: the role of the cardiac autonomic nervous system. J Atr Fibrillation. 2020;13:2400. - PMC - PubMed
    1. Lau DH, Schotten U, Mahajan R, et al. Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications. Eur Heart J. 2016;37:1573–1581. - PubMed
    1. Schotten U, Verheule S, Kirchhof P, et al. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol Rev. 2011;91:265–325. - PubMed

Genetics

    1. Lubitz SA, Yin X, Fontes JD, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010;304:2263–2269. - PMC - PubMed
    1. Brugada R, Tapscott T, Czernuszewicz GZ, et al. Identification of a genetic locus for familial atrial fibrillation. N Engl J Med. 1997;336:905–911. - PubMed
    1. Chen YH, Xu SJ, Bendahhou S, et al. KCNQ1 gain-of-function mutation in familial atrial fibrillation. Science. 2003;299:251–254. - PubMed
    1. Weng LC, Choi SH, Klarin D, et al. Heritability of atrial fibrillation. Circ Cardiovasc Genet. 2017;10:e001838. - PMC - PubMed
    1. Roselli C, Chaffin MD, Weng LC, et al. Multi-ethnic genome-wide association study for atrial fibrillation. Nat Genet. 2018;50:1225–1233. - PMC - PubMed

Addressing Health Inequities and Barriers to AF Management

    1. Kim D, Yang PS, You SC, et al. Treatment timing and the effects of rhythm control strategy in patients with atrial fibrillation: nationwide cohort study. BMJ. 2021;373:n991. - PMC - PubMed
    1. Tamirisa KP, Al-Khatib SM, Mohanty S, et al. Racial and ethnic differences in the management of atrial fibrillation. CJC Open. 2021;3:S137–S148. - PMC - PubMed
    1. Lunde ED, Nielsen PB, Riahi S, et al. Associations between socioeconomic status, atrial fibrillation, and outcomes: a systematic review. Expert Rev Cardiovasc Ther. 2018;16:857–873. - PubMed
    1. Hagengaard L, Andersen MP, Polcwiartek C, et al. Socioeconomic differences in outcomes after hospital admission for atrial fibrillation or flutter. Eur Heart J Qual Care Clin Outcomes. 2021;7:295–303. - PubMed
    1. Harrington RA, Califf RM, Balamurugan A, et al. Call to action: rural health: a presidential advisory from the American Heart Association and American Stroke Association. Circulation. 2020;141:e615–e644. - PubMed

Shared Decision-Making (SDM) in AF Management

    1. Kunneman M, Branda ME, Hargraves IG, et al. Assessment of shared decision-making for stroke prevention in patients with atrial fibrillation: a randomized clinical trial. JAMA Intern Med. 2020;180:1215–1224. - PMC - PubMed
    1. Wang PJ, Lu Y, Mahaffey KW, et al. A randomized clinical trial to evaluate an atrial fibrillation stroke prevention shared decision-making pathway. J Am Heart Assoc. 2022;12:e8009. - PMC - PubMed
    1. Torres Roldan VD, Brand-McCarthy SR, Ponce OJ, et al. Shared decision making tools for people facing stroke prevention strategies in atrial fibrillation: a systematic review and environmental scan. Med Decis Making. 2021;41:540–549. - PMC - PubMed
    1. Song D, Zhou J, Fan T, et al. Decision aids for shared decision-making and appropriate anticoagulation therapy in patients with atrial fibrillation: a systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2022;21:97–106. - PubMed
    1. Chung MK, Fagerlin A, Wang PJ, et al. Shared decision making in cardiac electrophysiology procedures and arrhythmia management. Circ Arrhythm Electrophysiol. 2021;14:e007958. - PMC - PubMed

Risk Stratification and Population Screening

    1. Himmelreich JCL, Veelers L, Lucassen WAM, et al. Prediction models for atrial fibrillation applicable in the community: a systematic review and meta-analysis. Europace. 2020;22:684–694. - PMC - PubMed
    1. Alonso A, Krijthe BP, Aspelund T, et al. Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium. J Am Heart Assoc. 2013;2:e000102. - PMC - PubMed
    1. Li YG, Pastori D, Farcomeni A, et al. A simple clinical risk score (C2HEST) for predicting incident atrial fibrillation in asian subjects: derivation in 471 446 Chinese subjects, with internal validation and external application in 451 199 Korean subjects. Chest. 2019;155:510–518. - PMC - PubMed
    1. Hu WS, Lin CL. Prediction of new-onset atrial fibrillation for general population in Asia: a comparison of C2HEST and HATCH scores. Int J Cardiol. 2020;313:60–63. - PubMed
    1. Biersteker TE, Schalij MJ, Treskes RW. Impact of mobile health devices for the detection of atrial fibrillation: systematic review. JMIR Mhealth Uhealth. 2021;9:e26161. - PMC - PubMed

Basic Clinical Evaluation

    1. Koyama J, Ray-Sequin PA, Falk RH. Longitudinal myocardial function assessed by tissue velocity, strain, and strain rate tissue Doppler echocardiography in patients with AL (primary) cardiac amyloidosis. Circulation. 2003;107:2446–2452. - PubMed
    1. Reddy YNV, Obokata M, Verbrugge FH, et al. Atrial dysfunction in patients with heart failure with preserved ejection fraction and atrial fibrillation. J Am Coll Cardiol. 2020;76:1051–1064. - PMC - PubMed
    1. Ma XX, Boldt LH, Zhang YL, et al. Clinical relevance of left atrial strain to predict recurrence of atrial fibrillation after catheter ablation: a meta-analysis. Echocardiogr. 2016;33:724–733. - PubMed
    1. Costa FM, Ferreira AM, Oliveira S, et al. Left atrial volume is more important than the type of atrial fibrillation in predicting the long-term success of catheter ablation. Int J Cardiol. 2015;184:56–61. - PubMed
    1. Shang W, Li L, Huang S, et al. Chronic kidney disease and the risk of new-onset atrial fibrillation: a meta-analysis of prospective cohort studies. PLoS One. 2016;11:e0155581. - PMC - PubMed

Rhythm Monitoring Tools and Methods

    1. Yang TY, Huang L, Malwade S, et al. Diagnostic accuracy of ambulatory devices in detecting atrial fibrillation: systematic review and meta-analysis. JMIR Mhealth Uhealth. 2021;9:e26167. - PMC - PubMed
    1. Prasitlumkum N, Cheungpasitporn W, Chokesuwattanaskul A, et al. Diagnostic accuracy of smart gadgets/wearable devices in detecting atrial fibrillation: a systematic review and meta-analysis. Arch Cardiovasc Dis. 2021;114:4–16. - PubMed
    1. Wong KC, Klimis H, Lowres N, et al. Diagnostic accuracy of handheld electrocardiogram devices in detecting atrial fibrillation in adults in community versus hospital settings: a systematic review and meta-analysis. Heart. 2020;106:1211–1217. - PubMed
    1. Kapa S, Epstein AE, Callans DJ, et al. Assessing arrhythmia burden after catheter ablation of atrial fibrillation using an implantable loop recorder: the ABACUS study. J Cardiovasc Electrophysiol. 2013;24:875–881. - PubMed
    1. Podd SJ, Sugihara C, Furniss SS, et al. Are implantable cardiac monitors the 'gold standard' for atrial fibrillation detection? A prospective randomized trial comparing atrial fibrillation monitoring using implantable cardiac monitors and DDDRP permanent pacemakers in post atrial fibrillation ablation patients. Europace. 2016;18:1000–1005. - PubMed

Primary Prevention

    1. Tedrow UB, Conen D, Ridker PM, et al. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation the WHS (women's health study). J Am Coll Cardiol. 2010;55:2319–2327. - PMC - PubMed
    1. Elliott AD, Linz D, Mishima R, et al. Association between physical activity and risk of incident arrhythmias in 402 406 individuals: evidence from the UK Biobank cohort. Eur Heart J. 2020;41:1479–1486. - PubMed
    1. Gallagher C, Hendriks JML, Elliott AD, et al. Alcohol and incident atrial fibrillation - a systematic review and meta-analysis. Int J Cardiol. 2017;246:46–52. - PubMed
    1. Aune D, Schlesinger S, Norat T, et al. Tobacco smoking and the risk of atrial fibrillation: a systematic review and meta-analysis of prospective studies. Eur J Prev Cardiol. 2018;25:1437–1451. - PubMed
    1. Aune D, Feng T, Schlesinger S, et al. Diabetes mellitus, blood glucose and the risk of atrial fibrillation: a systematic review and meta-analysis of cohort studies. J Diabetes Complications. 2018;32:501–511. - PubMed

Weight Loss in Individuals Who Are Overweight or Obese

    1. Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310:2050–2060. - PubMed
    1. Pathak RK, Middeldorp ME, Meredith M, et al. Long-term effect of goal-directed weight management in an atrial fibrillation cohort: a long-term follow-up study (LEGACY). J Am Coll Cardiol. 2015;65:2159–2169. - PubMed
    1. Pathak RK, Middeldorp ME, Lau DH, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64:2222–2231. - PubMed
    1. Middeldorp ME, Pathak RK, Meredith M, et al. PREVEntion and regReSsive Effect of weight-loss and risk factor modification on Atrial Fibrillation: the REVERSE-AF study. Europace. 2018;20:1929–1935. - PubMed
    1. Wong CX, Sullivan T, Sun MT, et al. Obesity and the risk of incident, postoperative, and post-ablation atrial fibrillation: a meta-analysis of 626 603 individuals in 51 studies. JACC: Clin Electrophysiol. 2015;1:139–152. - PubMed

Physical Fitness

    1. Hegbom F, Stavem K, Sire S, et al. Effects of short-term exercise training on symptoms and quality of life in patients with chronic atrial fibrillation. Int J Cardiol. 2007;116:86–92. - PubMed
    1. Malmo V, Nes BM, Amundsen BH, et al. Aerobic interval training reduces the burden of atrial fibrillation in the short term: a randomized trial. Circulation. 2016;133:466–473. - PubMed
    1. Elliott AD, Verdicchio CV, Mahajan R, et al. An exercise and physical activity program in patients with atrial fibrillation: the ACTIVE-AF randomized controlled trial. JACC Clin Electrophysiol. 2023;9:455–465. - PubMed
    1. Pathak RK, Elliott A, Middeldorp ME, et al. Impact of CARDIOrespiratory FITness on arrhythmia recurrence in obese individuals with atrial fibrillation: the CARDIO-FIT study. J Am Coll Cardiol. 2015;66:985–996. - PubMed
    1. Oesterle A, Giancaterino S, Van Noord MG, et al. Effects of supervised exercise training on atrial fibrillation: a meta-analysis of randomized controlled trials. J Cardiopulm Rehabil Prev. 2022;42:258–265. - PubMed

Smoking Cessation

    1. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e596–e646. - PMC - PubMed
    1. Patnode CD, Henderson JT, Thompson JH, et al. Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the US Preventive Services Task Force. Ann Intern Med. 2015;163:608–621. - PubMed
    1. Choi S, Chang J, Kim K, et al. Association of smoking cessation after atrial fibrillation diagnosis on the risk of cardiovascular disease: a cohort study of South Korean men. BMC Public Health. 2020;20:168. - PMC - PubMed
    1. Benz AP, Healey JS, Chin A, et al. Stroke risk prediction in patients with atrial fibrillation with and without rheumatic heart disease. Cardiovasc Res. 2022;118:295–304. - PubMed
    1. Chatterjee NA, Chae CU, Kim E, et al. Modifiable risk factors for incident heart failure in atrial fibrillation. JACC Heart Fail. 2017;5:552–560. - PMC - PubMed

Alcohol Consumption

    1. Voskoboinik A, Kalman JM, De Silva A, et al. Alcohol abstinence in drinkers with atrial fibrillation. N Engl J Med. 2020;382:20–28. - PubMed
    1. Marcus GM, Dukes JW, Vittinghoff E, et al. A randomized, double-blind, placebo-controlled trial of intravenous alcohol to assess changes in atrial electrophysiology. JACC Clin Electrophysiol. 2021;7:662–670. - PMC - PubMed
    1. Marcus GM, Modrow MF, Schmid CH, et al. Individualized studies of triggers of paroxysmal atrial fibrillation: the I-STOP-AFib randomized clinical trial. JAMA Cardiol. 2022;7:167–174. - PMC - PubMed
    1. Marcus GM, Vittinghoff E, Whitman IR, et al. Acute consumption of alcohol and discrete atrial fibrillation events. Ann Intern Med. 2021;174:1503–1509. - PubMed
    1. Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310:2050–2060. - PubMed

Caffeine Consumption

    1. Lagier D, Nee L, Guieu R, et al. Peri-operative oral caffeine does not prevent postoperative atrial fibrillation after heart valve surgery with cardiopulmonary bypass: a randomised controlled clinical trial. Eur J Anaesthesiol. 2018;35:911–918. - PubMed
    1. Marcus GM, Modrow MF, Schmid CH, et al. Individualized Studies of triggers of paroxysmal atrial fibrillation: the I-STOP-AFib randomized clinical trial. JAMA Cardiol. 2022;7:167–174. - PMC - PubMed
    1. Caldeira D, Martins C, Alves LB, et al. Caffeine does not increase the risk of atrial fibrillation: a systematic review and meta-analysis of observational studies. Heart. 2013;99:1383–1389. - PubMed
    1. Conen D, Chiuve SE, Everett BM, et al. Caffeine consumption and incident atrial fibrillation in women. Am J Clin Nutr. 2010;92:509–514. - PMC - PubMed
    1. Bazal P, Gea A, Navarro AM, et al. Caffeinated coffee consumption and risk of atrial fibrillation in two Spanish cohorts. Eur J Prev Cardiol. 2021;28:648–657. - PubMed

Diet and Dietary Supplementation

    1. Aleksova A, Masson S, Maggioni AP, et al. n-3 polyunsaturated fatty acids and atrial fibrillation in patients with chronic heart failure: the GISSI-HF trial. Eur J Heart Fail. 2013;15:1289–1295. - PubMed
    1. Metcalf RG, Skuladottir GV, Indridason OS, et al. U-shaped relationship between tissue docosahexaenoic acid and atrial fibrillation following cardiac surgery. Eur J Clin Nutr. 2014;68:114–118. - PubMed
    1. Gencer B, Djousse L, Al-Ramady OT, et al. Effect of long-term marine omega-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021;144:1981–1990. - PMC - PubMed
    1. Darghosian L, Free M, Li J, et al. Effect of omega-three polyunsaturated fatty acids on inflammation, oxidative stress, and recurrence of atrial fibrillation. Am J Cardiol. 2015;115:196–201. - PMC - PubMed
    1. Kowey PR, Reiffel JA, Ellenbogen KA, et al. Efficacy and safety of prescription omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: a randomized controlled trial. JAMA. 2010;304:2363–2372. - PubMed

Diabetes

    1. Echouffo-Tcheugui JB, Shrader P, Thomas L, et al. Care patterns and outcomes in atrial fibrillation patients with and without diabetes: ORBIT-AF registry. J Am Coll Cardiol. 2017;70:1325–1335. - PubMed
    1. Patti G, Di Gioia G, Cavallari I, et al. Safety and efficacy of nonvitamin K antagonist oral anticoagulants versus warfarin in diabetic patients with atrial fibrillation: a study-level meta-analysis of phase III randomized trials. Diabetes Metab Res Rev. 2017;33:e2876. - PubMed
    1. Donnellan E, Aagaard P, Kanj M, et al. Association between pre-ablation glycemic control and outcomes among patients with diabetes undergoing atrial fibrillation ablation. JACC Clin Electrophysiol. 2019;5:897–903. - PubMed

Treatment of Hypertension

    1. Neefs J, van den Berg NW, Limpens J, et al. Aldosterone pathway blockade to prevent atrial fibrillation: a systematic review and meta-analysis. Int J Cardiol. 2017;231:155–161. - PubMed
    1. Steinberg JS, Shabanov V, Ponomarev D, et al. Effect of renal denervation and catheter ablation vs catheter ablation alone on atrial fibrillation recurrence among patients with paroxysmal atrial fibrillation and hypertension: the ERADICATE-AF randomized clinical trial. JAMA. 2020;323:248–255. - PMC - PubMed
    1. Pathak RK, Middeldorp ME, Lau DH, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64:2222–2231. - PubMed
    1. Rienstra M, Hobbelt AH, Alings M, et al. Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial. Eur Heart J. 2018;39:2987–2996. - PubMed
    1. Pinho-Gomes AC, Azevedo L, Copland E, et al. Blood pressure-lowering treatment for the prevention of cardiovascular events in patients with atrial fibrillation: an individual participant data meta-analysis. PLoS Med. 2021;18:e1003599. - PMC - PubMed

Sleep

    1. Kadhim K, Middeldorp ME, Elliott AD, et al. Prevalence and assessment of sleep-disordered breathing in patients with atrial fibrillation: a systematic review and meta-analysis. Can J Cardiol. 2021;37:1846–1856. - PubMed
    1. Mohammadieh AM, Sutherland K, Kanagaratnam LB, et al. Clinical screening tools for obstructive sleep apnea in a population with atrial fibrillation: a diagnostic accuracy trial. J Clin Sleep Med. 2021;17:1015–1024. - PMC - PubMed
    1. Linz D, Brooks AG, Elliott AD, et al. Variability of sleep apnea severity and risk of atrial fibrillation: the VARIOSA-AF study. JACC Clin Electrophysiol. 2019;5:692–701. - PubMed
    1. Abumuamar AM, Dorian P, Newman D, et al. The prevalence of obstructive sleep apnea in patients with atrial fibrillation. Clin Cardiol. 2018;41:601–607. - PMC - PubMed
    1. Platek AE, Szymanski FM, Filipiak KJ, et al. Stratification of cardiovascular risk in patients with atrial fibrillation and obstructive sleep apnea-validity of the 2MACE score. Sleep Breath. 2017;21:601–606. - PMC - PubMed

Comprehensive Care

    1. Voskoboinik A, Kalman JM, De Silva A, et al. Alcohol abstinence in drinkers with atrial fibrillation. N Engl J Med. 2020;382:20–28. - PubMed
    1. Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310:2050–2060. - PubMed
    1. Rienstra M, Hobbelt AH, Alings M, et al. Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial. Eur Heart J. 2018;39:2987–2996. - PubMed
    1. Hendriks JM, de Wit R, Crijns HJ, et al. Nurse-led care vs usual care for patients with atrial fibrillation: results of a randomized trial of integrated chronic care vs routine clinical care in ambulatory patients with atrial fibrillation. Eur Heart J. 2012;33:2692–2699. - PubMed
    1. Guo Y, Lane DA, Wang L, et al. Mobile health technology to improve care for patients with atrial fibrillation. J Am Coll Cardiol. 2020;75:1523–1534. - PubMed

Risk Stratification Schemes

    1. Singer DE, Chang Y, Borowsky LH, et al. A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. J Am Heart Assoc. 2013;2:e000250. - PMC - PubMed
    1. Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137:263–272. - PubMed
    1. Fox KAA, Lucas JE, Pieper KS, et al. Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation. BMJ Open. 2017;7:e017157. - PMC - PubMed
    1. Quinn GR, Severdija ON, Chang Y, et al. Wide variation in reported rates of stroke across cohorts of patients with atrial fibrillation. Circulation. 2017;135:208–219. - PubMed
    1. Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138:1093–1100. - PubMed

Risk-Based Selection of Oral Anticoagulation: Balancing Risks and Benefits

    1. Al-Khatib SM, Thomas L, Wallentin L, et al. Outcomes of apixaban vs warfarin by type and duration of atrial fibrillation: results from the ARISTOTLE trial. Eur Heart J. 2013;34:2464–2471. - PubMed
    1. Link MS, Giugliano RP, Ruff CT, et al. Stroke and mortality risk in patients with various patterns of atrial fibrillation: results from the ENGAGE AF-TIMI 48 Trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48). Circ Arrhythm Electrophysiol. 2017;10:e004267. - PubMed
    1. Steinberg BA, Hellkamp AS, Lokhnygina Y, et al. Higher risk of death and stroke in patients with persistent vs paroxysmal atrial fibrillation: results from the ROCKET-AF Trial. Eur Heart J. 2015;36:288–296. - PMC - PubMed
    1. Chao TF, Lip GYH, Lin YJ, et al. Incident risk factors and major bleeding in patients with atrial fibrillation treated with oral anticoagulants: a comparison of baseline, follow-up and delta HAS-BLED scores with an approach focused on modifiable bleeding risk factors. Thromb Haemost. 2018;118:768–777. - PubMed
    1. Minhas AS, Jiang Q, Gu X, et al. Renal function in atrial fibrillation patients switched from warfarin to a direct oral anticoagulant. J Thromb Thrombolysis. 2016;42:566–572. - PubMed

Oral Anticoagulants

    1. Zhu J, Alexander GC, Nazarian S, et al. Trends and variation in oral anticoagulant choice in patients with atrial fibrillation, 2010–2017. Pharmacotherapy. 2018;38:907–920. - PMC - PubMed
    1. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–992. - PubMed
    1. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–1151. - PubMed
    1. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–2104. - PubMed
    1. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–891. - PubMed

Antithrombotic Therapy

    1. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–1151. - PubMed
    1. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–891. - PubMed
    1. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–992. - PubMed
    1. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–2104. - PubMed
    1. Lopez-Lopez JA, Sterne JAC, Thom HHZ, et al. Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis. Bmj. 2017;359:j5058. - PMC - PubMed

Considerations in Managing Anticoagulants

    1. Mueck W, Kubitza D, Becka M. Co-administration of rivaroxaban with drugs that share its elimination pathways: pharmacokinetic effects in healthy subjects. Br J Clin Pharmacol. 2013;76:455–466. - PMC - PubMed
    1. Frost CE, Byon W, Song Y, et al. Effect of ketoconazole and diltiazem on the pharmacokinetics of apixaban, an oral direct factor Xa inhibitor. Br J Clin Pharmacol. 2015;79:838–846. - PMC - PubMed
    1. Parasrampuria DA, Mendell J, Shi M, et al. Edoxaban drug-drug interactions with ketoconazole, erythromycin, and cyclosporine. Br J Clin Pharmacol. 2016;82:1591–1600. - PMC - PubMed
    1. Perlman A, Goldstein R, Choshen Cohen L, et al. Effect of enzyme-inducing antiseizure medications on the risk of sub-therapeutic concentrations of direct oral anticoagulants: a retrospective cohort study. CNS Drugs. 2021;35:305–316. - PMC - PubMed
    1. Vakkalagadda B, Frost C, Byon W, et al. Effect of rifampin on the pharmacokinetics of apixaban, an oral direct inhibitor of factor Xa. Am J Cardiovasc Drugs. 2016;16:119–127. - PubMed

Silent AF and Stroke of Undetermined Cause

    1. Gladstone DJ, Spring M, Dorian P, et al. Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med. 2014;370:2467–2477. - PubMed
    1. Saver JL. CLINICAL PRACTICE Cryptogenic Stroke. N Engl J Med. 2016;374:2065–2074. - PubMed
    1. Ibeh C, Elkind MSV. Stroke prevention after cryptogenic stroke. Curr Cardiol Rep. 2021;23:174. - PMC - PubMed
    1. Melis F, Guido M, Amellone C, et al. Prevalence and predictors of atrial fibrillation in patients with embolic stroke of undetermined source: a real-life single-center retrospective study. Neurol Sci. 2021;42:3707–3714. - PubMed
    1. Victor CU, Carolina PE, Jorge TR, et al. Incidence and predictive factors of hidden atrial fibrillation detected by implantable loop recorder after an embolic stroke of undetermined source. J Atr Fibrillation. 2018;11:2078. - PMC - PubMed

Oral Anticoagulation for Device-Detected Atrial High-Rate Episodes Among Patients Without a Previous Diagnosis of AF

    1. Van Gelder IC, Healey JS, Crijns H, et al. Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT. Eur Heart J. 2017;38:1339–1344. - PubMed
    1. Kaplan RM, Koehler J, Ziegler PD, et al. Stroke risk as a function of atrial fibrillation duration and CHA2DS2-VASc score. Circulation. 2019;140:1639–1646. - PubMed
    1. Perino AC, Fan J, Askari M, et al. Practice variation in anticoagulation prescription and outcomes after device-detected atrial fibrillation. Circulation. 2019;139:2502–2512. - PMC - PubMed
    1. Swiryn S, Orlov MV, Benditt DG, et al. Clinical implications of brief device-detected atrial tachyarrhythmias in a cardiac rhythm management device population: results from the registry of atrial tachycardia and atrial fibrillation episodes. Circulation. 2016;134:1130–1140. - PubMed
    1. Boriani G, Glotzer TV, Santini M, et al. Device-detected atrial fibrillation and risk for stroke: an analysis of >10 000 patients from the SOS AF project (Stroke preventiOn Strategies based on Atrial Fibrillation information from implanted devices). Eur Heart J. 2014;35:508–516. - PMC - PubMed

Percutaneous Approaches to Occlude the LAA

    1. Reddy VY, Sievert H, Halperin J, et al. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA. 2014;312:1988–1998. - PubMed
    1. Holmes DR Jr, Kar S, Price MJ, et al. Prospective randomized evaluation of the Watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol. 2014;64:1–12. - PubMed
    1. Reddy VY, Doshi SK, Kar S, et al. 5-Year outcomes after left atrial appendage closure: from the PREVAIL and PROTECT AF trials. J Am Coll Cardiol. 2017;70:2964–2975. - PubMed
    1. Osmancik P, Herman D, Neuzil P, et al. Left atrial appendage closure versus direct oral anticoagulants in high-risk patients with atrial fibrillation. J Am Coll Cardiol. 2020;75:3122–3135. - PubMed
    1. Reddy VY, Mobius-Winkler S, Miller MA, et al. Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation: the ASAP study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology). J Am Coll Cardiol. 2013;61:2551–2556. - PubMed

Cardiac Surgery—LAA Exclusion/Excision

    1. Whitlock RP, Belley-Cote EP, Paparella D, et al. Left atrial appendage occlusion during cardiac surgery to prevent stroke. N Engl J Med. 2021;384:2081–2091. - PubMed
    1. Friedman DJ, Piccini JP, Wang T, et al. Association between left atrial appendage occlusion and readmission for thromboembolism among patients with atrial fibrillation undergoing concomitant cardiac surgery. JAMA. 2018;319:365–374. - PMC - PubMed
    1. Martín Gutiérrez E, Castaño M, Gualis J, et al. Beneficial effect of left atrial appendage closure during cardiac surgery: a meta-analysis of 280 585 patients. Eur J Cardiothorac Surg. 2020;57:252–262. - PubMed
    1. Healey JS, Crystal E, Lamy A, et al. Left Atrial Appendage Occlusion Study (LAAOS): results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke. Am Heart J. 2005;150:288–293. - PubMed
    1. Aryana A, Singh SK, Singh SM, et al. Association between incomplete surgical ligation of left atrial appendage and stroke and systemic embolization. Heart Rhythm. 2015;12:1431–1437. - PubMed

Active Bleeding on Anticoagulant Therapy and Reversal Drugs

    1. Pollack CV Jr, Reilly PA, van Ryn J, et al. Idarucizumab for dabigatran reversal - full cohort analysis. N Engl J Med. 2017;377:431–441. - PubMed
    1. Van der Wall SJ, Lopes RD, Aisenberg J, et al. Idarucizumab for dabigatran reversal in the management of patients with gastrointestinal bleeding. Circulation. 2019;139:748–756. - PubMed
    1. Eikelboom JW, van Ryn J, Reilly P, et al. Dabigatran reversal with idarucizumab in patients with renal impairment. J Am Coll Cardiol. 2019;74:1760–1768. - PubMed
    1. Schulman S, Ritchie B, Nahirniak S, et al. Reversal of dabigatran-associated major bleeding with activated prothrombin concentrate: A prospective cohort study. Thromb Res. 2017;152:44–48. - PubMed
    1. Eerenberg ES, Kamphuisen PW, Sijpkens MK, et al. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation. 2011;124:1573–1579. - PubMed

Management of Patients With AF and ICH

    1. Kuramatsu JB, Sembill JA, Gerner ST, et al. Management of therapeutic anticoagulation in patients with intracerebral haemorrhage and mechanical heart valves. Eur Heart J. 2018;39:1709–1723. - PMC - PubMed
    1. Korompoki E, Filippidis FT, Nielsen PB, et al. Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation. Neurology. 2017;89:687–696. - PMC - PubMed
    1. Pennlert J, Overholser R, Asplund K, et al. Optimal timing of anticoagulant treatment after intracerebral hemorrhage in patients with atrial fibrillation. Stroke. 2017;48:314–320. - PubMed
    1. Nielsen PB, Larsen TB, Skjoth F, et al. Restarting anticoagulant treatment after intracranial hemorrhage in patients with atrial fibrillation and the impact on recurrent stroke, mortality, and bleeding: a nationwide cohort study. Circulation. 2015;132:517–525. - PubMed
    1. Murthy SB, Gupta A, Merkler AE, et al. Restarting anticoagulant therapy after intracranial hemorrhage: a systematic review and meta-analysis. Stroke. 2017;48:1594–1600. - PMC - PubMed

Periprocedural Management

    1. Douketis JD, Spyropoulos AC, Kaatz S, et al. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med. 2015;373:823–833. - PMC - PubMed
    1. Becerra AF, Cornavaca MT, Revigliono JI, et al. Perioperative management of vitamin K antagonists in patients with low thromboembolic risk undergoing elective surgery: a prospective experience. Med Clin (Barc). 2017;149:281–286. - PubMed
    1. Siegal D, Yudin J, Kaatz S, et al. Periprocedural heparin bridging in patients receiving vitamin K antagonists: systematic review and meta-analysis of bleeding and thromboembolic rates. Circulation. 2012;126:1630–1639. - PubMed
    1. Douketis JD, Spyropoulos AC, Duncan J, et al. Perioperative management of patients with atrial fibrillation receiving a direct oral anticoagulant. JAMA Intern Med. 2019;179:1469–1478. - PMC - PubMed
    1. Birnie DH, Healey JS, Wells GA, et al. Pacemaker or defibrillator surgery without interruption of anticoagulation. N Engl J Med. 2013;368:2084–2093. - PubMed

AF Complicating ACS or PCI

    1. Lopes RD, Heizer G, Aronson R, et al. Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation. N Engl J Med. 2019;380:1509–1524. - PubMed
    1. Cannon CP, Bhatt DL, Oldgren J, et al. Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation. N Engl J Med. 2017;377:1513–1524. - PubMed
    1. Vranckx P, Valgimigli M, Eckardt L, et al. Edoxaban-based versus vitamin K antagonist-based antithrombotic regimen after successful coronary stenting in patients with atrial fibrillation (ENTRUST-AF PCI): a randomised, open-label, phase 3b trial. Lancet. 2019;394:1335–1343. - PubMed
    1. Gibson CM, Mehran R, Bode C, et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI. N Engl J Med. 2016;375:2423–2434. - PubMed
    1. Potpara TS, Mujovic N, Proietti M, et al. Revisiting the effects of omitting aspirin in combined antithrombotic therapies for atrial fibrillation and acute coronary syndromes or percutaneous coronary interventions: meta-analysis of pooled data from the PIONEER AF-PCI, RE-DUAL PCI, and AUGUSTUS trials. Europace. 2020;22:33–46. - PubMed

Chronic Coronary Disease (CCD)

    1. Yasuda S, Kaikita K, Akao M, et al. Antithrombotic therapy for atrial fibrillation with stable coronary disease. N Engl J Med. 2019;381:1103–1113. - PubMed
    1. Matsumura-Nakano Y, Shizuta S, Komasa A, et al. Open-label randomized trial comparing oral anticoagulation with and without single antiplatelet therapy in patients with atrial fibrillation and stable coronary artery disease beyond 1 year after coronary stent implantation. Circulation. 2019;139:604–616. - PubMed
    1. Matoba T, Yasuda S, Kaikita K, et al. Rivaroxaban monotherapy in patients with atrial fibrillation after coronary stenting: insights from the AFIRE trial. JACC Cardiovasc Interv. 2021;14:2330–2340. - PubMed

Peripheral Artery Disease (PAD)

    1. Zhang H, Xue Z, Yi D, et al. Non-vitamin K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation with coronary or peripheral artery disease. Int Heart J. 2020;61:231–238. - PubMed
    1. Jones WS, Hellkamp AS, Halperin J, et al. Efficacy and safety of rivaroxaban compared with warfarin in patients with peripheral artery disease and non-valvular atrial fibrillation: insights from ROCKET AF. Eur Heart J. 2014;35:242–249. - PubMed
    1. Hu PT, Lopes RD, Stevens SR, et al. Efficacy and safety of apixaban compared with warfarin in patients with atrial fibrillation and peripheral artery disease: insights from the ARISTOTLE trial. J Am Heart Assoc. 2017;6:e004699. - PMC - PubMed
    1. Bonaca MP, Antman EM, Cunningham JW, et al. Ischaemic and bleeding risk in atrial fibrillation with and without peripheral artery disease and efficacy and safety of full- and half-dose edoxaban vs warfarin: insights from ENGAGE AF-TIMI 48. Eur Heart J Cardiovasc Pharmacother. 2022;8:695–706. - PubMed
    1. Inohara T, Shrader P, Pieper K, et al. Treatment of atrial fibrillation with concomitant coronary or peripheral artery disease: results from the outcomes registry for better informed treatment of atrial fibrillation II. Am Heart J. 2019;213:81–90. - PubMed

Chronic Kidney Disease (CKD)/Kidney Failure

    1. Kimachi M, Furukawa TA, Kimachi K, et al. Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease. Cochrane Database Syst Rev. 2017;11:Cd011373. - PMC - PubMed
    1. Ha JT, Neuen BL, Cheng LP, et al. Benefits and harms of oral anticoagulant therapy in chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2019;171:181–189. - PubMed
    1. Hart RG, Pearce LA, Asinger RW, et al. Warfarin in atrial fibrillation patients with moderate chronic kidney disease. Clin J Am Soc Nephrol. 2011;6:2599–2604. - PMC - PubMed
    1. Stanifer JW, Pokorney SD, Chertow GM, et al. Apixaban versus warfarin in patients with atrial fibrillation and advanced chronic kidney disease. Circulation. 2020;141:1384–1392. - PubMed
    1. Carrero JJ, Evans M, Szummer K, et al. Warfarin, kidney dysfunction, and outcomes following acute myocardial infarction in patients with atrial fibrillation. JAMA. 2014;311:919–928. - PubMed

AF in VHD

    1. Connolly SJ, Karthikeyan G, Ntsekhe M, et al. Rivaroxaban in rheumatic heart disease-associated atrial fibrillation. N Engl J Med. 2022;387:978–988. - PubMed
    1. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–1151. - PubMed
    1. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–891. - PubMed
    1. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–992. - PubMed
    1. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–2104. - PubMed

Anticoagulation of Typical AFL

    1. Gula LJ, Redfearn DP, Jenkyn KB, et al. Elevated incidence of atrial fibrillation and stroke in patients with atrial flutter-a population-based study. Can J Cardiol. 2018;34:774–783. - PubMed
    1. Gronefeld GC, Wegener F, Israel CW, et al. Thromboembolic risk of patients referred for radiofrequency catheter ablation of typical atrial flutter without prior appropriate anticoagulation therapy. Pacing Clin Electrophysiol. 2003;26:323–327. - PubMed
    1. Vadmann H, Nielsen PB, Hjortshøj SP, et al. Atrial flutter and thromboembolic risk: a systematic review. Heart. 2015;101:1446–1455. - PubMed
    1. Gallagher MM, Hennessy BJ, Edvardsson N, et al. Embolic complications of direct current cardioversion of atrial arrhythmias: association with low intensity of anticoagulation at the time of cardioversion. J Am Coll Cardiol. 2002;40:926–933. - PubMed
    1. Pérez FJ, Schubert CM, Parvez B, et al. Long-term outcomes after catheter ablation of cavo-tricuspid isthmus dependent atrial flutter: a meta-analysis. Circ Arrhyth Electrophysiol. 2009;2:393–401. - PubMed

Broad Considerations for Rate Control

    1. Wyse DG, Waldo AL, DiMarco JP, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347:1825–1833. - PubMed
    1. Van Gelder IC, Groenveld HF, Crijns HJ, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010;362:1363–1373. - PubMed
    1. Al-Khatib SM, Allen LaPointe NM, Chatterjee R, et al. Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review. Ann Intern Med. 2014;160:760–773. - PubMed
    1. Moschovitis G, Johnson LSB, Blum S, et al. Heart rate and adverse outcomes in patients with prevalent atrial fibrillation. Open Heart. 2021;8:e001606. - PMC - PubMed
    1. Song S, Ko JS, Lee HA, et al. Clinical implications of heart rate control in heart failure with atrial fibrillation: Multi-Center Prospective Observation Registry (CODE-AF Registry). Front Cardiovasc Med. 2022;9:787869. - PMC - PubMed

Specific Pharmacological Agents for Rate Control

    1. Ulimoen SR, Enger S, Carlson J, et al. Comparison of four single-drug regimens on ventricular rate and arrhythmia-related symptoms in patients with permanent atrial fibrillation. Am J Cardiol. 2013;111:225–230. - PubMed
    1. Nikolaidou T, Channer KS. Chronic atrial fibrillation: a systematic review of medical heart rate control management. Postgrad Med J. 2009;85:303–312. - PubMed

Acute Rate Control

    1. Platia EV, Michelson EL, Porterfield JK, et al. Esmolol versus verapamil in the acute treatment of atrial fibrillation or atrial flutter. Am J Cardiol. 1989;63:925–929. - PubMed
    1. Elkayam U Calcium channel blockers in heart failure. Cardiology. 1998;89(suppl 1):38–46. - PubMed
    1. Lan Q, Wu F, Han B, et al. Intravenous diltiazem versus metoprolol for atrial fibrillation with rapid ventricular rate: a meta-analysis. Am J Emerg Med. 2022;51:248–256. - PubMed
    1. Fromm C, Suau SJ, Cohen V, et al. Diltiazem vs metoprolol in the management of atrial fibrillation or flutter with rapid ventricular rate in the emergency department. J Emerg Med. 2015;49:175–182. - PubMed
    1. Intravenous digoxin in acute atrial fibrillation. Results of a randomized, placebo-controlled multicentre trial in 239 patients. The Digitalis in Acute Atrial Fibrillation (DAAF) Trial Group. Eur Heart J. 1997;18:649–654. - PubMed

Long-Term Rate Control

    1. Scheuermeyer FX, Grafstein E, Stenstrom R, et al. Safety and efficiency of calcium channel blockers versus beta-blockers for rate control in patients with atrial fibrillation and no acute underlying medical illness. Acad Emerg Med. 2013;20:222–230. - PubMed
    1. Zaman N, Naccarelli G, Foy A. A comparison of rate control agents for the treatment of atrial fibrillation: follow-up investigation of the AFFIRM study. J Cardiovasc Pharmacol Ther. 2021;26:328–334. - PubMed
    1. Lopes RD, Rordorf R, De Ferrari GM, et al. Digoxin and mortality in patients with atrial fibrillation. J Am Coll Cardiol. 2018;71:1063–1074. - PubMed
    1. Rathore SS, Curtis JP, Wang Y, et al. Association of serum digoxin concentration and outcomes in patients with heart failure. JAMA. 2003;289:871–878. - PubMed
    1. Adams KF Jr, Patterson JH, Gattis WA, et al. Relationship of serum digoxin concentration to mortality and morbidity in women in the digitalis investigation group trial: a retrospective analysis. J Am Coll Cardiol. 2005;46:497–504. - PubMed

Atrioventricular Nodal Ablation (AVNA)

    1. Geelen P, Brugada J, Andries E, et al. Ventricular fibrillation and sudden death after radiofrequency catheter ablation of the atrioventricular junction. Pacing Clin Electrophysiol. 1997;20:343–348. - PubMed
    1. Wang RX, Lee HC, Hodge DO, et al. Effect of pacing method on risk of sudden death after atrioventricular node ablation and pacemaker implantation in patients with atrial fibrillation. Heart Rhythm. 2013;10:696–701. - PubMed
    1. Brignole M, Menozzi C, Gianfranchi L, et al. Assessment of atrioventricular junction ablation and VVIR pacemaker versus pharmacological treatment in patients with heart failure and chronic atrial fibrillation: a randomized, controlled study. Circulation. 1998;98:953–960. - PubMed
    1. Lim KT, Davis MJ, Powell A, et al. Ablate and pace strategy for atrial fibrillation: long-term outcome of AIRCRAFT trial. Europace. 2007;9:498–505. - PubMed
    1. Wood MA, Brown-Mahoney C, Kay GN, et al. Clinical outcomes after ablation and pacing therapy for atrial fibrillation: a meta-analysis. Circulation. 2000;101:1138–1144. - PubMed

Goals of Therapy With Rhythm Control

    1. Santhanakrishnan R, Wang N, Larson MG, et al. Atrial fibrillation begets heart failure and vice versa: temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016;133:484–492. - PMC - PubMed
    1. Hsu LF, Jais P, Sanders P, et al. Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med. 2004;351:2373–2383. - PubMed
    1. Prabhu S, Costello BT, Taylor AJ, et al. Regression of diffuse ventricular fibrosis following restoration of sinus rhythm with catheter ablation in patients with atrial fibrillation and systolic dysfunction: a substudy of the CAMERA MRI trial. JACC Clin Electrophysiol. 2018;4:999–1007. - PubMed
    1. Stronati G, Guerra F, Urbinati A, et al. Tachycardiomyopathy in patients without underlying structural heart disease. J Clin Med. 2019;8:1411. - PMC - PubMed
    1. Jeong YH, Choi KJ, Song JM, et al. Diagnostic approach and treatment strategy in tachycardia-induced cardiomyopathy. Clin Cardiol. 2008;31:172–178. - PMC - PubMed

Electrical and Pharmacologic Cardioversion

    1. Crijns HJ, Weijs B, Fairley AM, et al. Contemporary real life cardioversion of atrial fibrillation: Results from the multinational RHYTHM-AF study. Int J Cardiol. 2014;172:588–594. - PubMed
    1. Hernandez-Madrid A, Svendsen JH, Lip GY, et al. Cardioversion for atrial fibrillation in current European practice: results of the European Heart Rhythm Association survey. Europace. 2013;15:915–918. - PubMed
    1. Pisters R, Nieuwlaat R, Prins MH, et al. Clinical correlates of immediate success and outcome at 1-year follow-up of real-world cardioversion of atrial fibrillation: the Euro Heart Survey. Europace. 2012;14:666–674. - PubMed
    1. Stiell IG, Clement CM, Brison RJ, et al. Variation in management of recent-onset atrial fibrillation and flutter among academic hospital emergency departments. Ann Emerg Med. 2011;57:13–21. - PubMed
    1. Dankner R, Shahar A, Novikov I, et al. Treatment of stable atrial fibrillation in the emergency department: a population-based comparison of electrical direct-current versus pharmacological cardioversion or conservative management. Cardiology. 2009;112:270–278. - PubMed

Prevention of Thromboembolism in the Setting of Cardioversion

    1. Klein AL, Grimm RA, Murray RD, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med. 2001;344:1411–1420. - PubMed
    1. Fatkin D, Kuchar DL, Thorburn CW, et al. Transesophageal echocardiography before and during direct current cardioversion of atrial fibrillation: evidence for “atrial stunning” as a mechanism of thromboembolic complications. J Am Coll Cardiol. 1994;23:307–316. - PubMed
    1. Grimm RA, Stewart WJ, Maloney JD, et al. Impact of electrical cardioversion for atrial fibrillation on left atrial appendage function and spontaneous echo contrast: characterization by simultaneous transesophageal echocardiography. J Am Coll Cardiol. 1993;22:1359–1366. - PubMed
    1. Manning WJ, Leeman DE, Gotch PJ, et al. Pulsed Doppler evaluation of atrial mechanical function after electrical cardioversion of atrial fibrillation. J Am Coll Cardiol. 1989;13:617–623. - PubMed
    1. Manning WJ, Silverman DI, Katz SE, et al. Impaired left atrial mechanical function after cardioversion: relation to the duration of atrial fibrillation. J Am Coll Cardiol. 1994;23:1535–1540. - PubMed

Electrical Cardioversion

    1. Dankner R, Shahar A, Novikov I, et al. Treatment of stable atrial fibrillation in the emergency department: a population-based comparison of electrical direct-current versus pharmacological cardioversion or conservative management. Cardiology. 2009;112:270–278. - PubMed
    1. Stiell IG, Sivilotti MLA, Taljaard M, et al. Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomised trial. Lancet. 2020;395:339–349. - PubMed
    1. Lown B Electrical reversion of cardiac arrhythmias. Br Heart J. 1967;29:469–489. - PMC - PubMed
    1. Mittal S, Ayati S, Stein KM, et al. Transthoracic cardioversion of atrial fibrillation: comparison of rectilinear biphasic versus damped sine wave monophasic shocks. Circulation. 2000;101:1282–1287. - PubMed
    1. Schmidt AS, Lauridsen KG, Torp P, et al. Maximum-fixed energy shocks for cardioverting atrial fibrillation. Eur Heart J. 2020;41:626–631. - PubMed

Pharmacological Cardioversion

    1. Dankner R, Shahar A, Novikov I, et al. Treatment of stable atrial fibrillation in the emergency department: a population-based comparison of electrical direct-current versus pharmacological cardioversion or conservative management. Cardiology. 2009;112:270–278. - PubMed
    1. Stambler BS, Wood MA, Ellenbogen KA, et al. Efficacy and safety of repeated intravenous doses of ibutilide for rapid conversion of atrial flutter or fibrillation Ibutilide Repeat Dose Study Investigators. Circulation. 1996;94:1613–1621. - PubMed
    1. Ellenbogen KA, Stambler BS, Wood MA, et al. Efficacy of intravenous ibutilide for rapid termination of atrial fibrillation and atrial flutter: a dose-response study. J Am Coll Cardiol. 1996;28:130–136. - PubMed
    1. Hou ZY, Chang MS, Chen CY, et al. Acute treatment of recent-onset atrial fibrillation and flutter with a tailored dosing regimen of intravenous amiodarone A randomized, digoxin-controlled study. Eur Heart J. 1995;16:521–528. - PubMed
    1. Kochiadakis GE, Igoumenidis NE, Simantirakis EN, et al. Intravenous propafenone versus intravenous amiodarone in the management of atrial fibrillation of recent onset: a placebo-controlled study. Pacing Clin Electrophysiol. 1998;21:2475–2479. - PubMed

Specific Drug Therapy for Long-Term Maintenance of Sinus Rhythm

    1. Pedersen OD, Bagger H, Keller N, et al. Efficacy of dofetilide in the treatment of atrial fibrillation-flutter in patients with reduced left ventricular function: a Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) substudy. Circulation. 2001;104:292–296. - PubMed
    1. Deedwania PC, Singh BN, Ellenbogen K, et al. Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the Veterans Affairs Congestive Heart Failure Survival Trial of Antiarrhythmic Therapy (CHF-STAT). The Department of Veterans Affairs CHF-STAT Investigators. Circulation. 1998;98:2574–2579. - PubMed
    1. Anderson JL, Gilbert EM, Alpert BL, et al. Prevention of symptomatic recurrences of paroxysmal atrial fibrillation in patients initially tolerating antiarrhythmic therapy. A multicenter, double-blind, crossover study of flecainide and placebo with transtelephonic monitoring. Flecainide Supraventricular Tachycardia Study Group. Circulation. 1989;80:1557–1570. - PubMed
    1. Kirchhof P, Andresen D, Bosch R, et al. Short-term versus long-term antiarrhythmic drug treatment after cardioversion of atrial fibrillation (Flec-SL): a prospective, randomised, open-label, blinded endpoint assessment trial. Lancet. 2012;380:238–246. - PubMed
    1. Valembois L, Audureau E, Takeda A, et al. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2019;9:Cd005049. - PMC - PubMed

Inpatient Initiation of Antiarrhythmic Agents

    1. Singh S, Zoble RG, Yellen L, et al. Efficacy and safety of oral dofetilide in converting to and maintaining sinus rhythm in patients with chronic atrial fibrillation or atrial flutter: the Symptomatic Atrial Fibrillation Investigative Research on Dofetilide (SAFIRE-D) study. Circulation. 2000;102:2385–2390. - PubMed
    1. Abraham JM, Saliba WI, Vekstein C, et al. Safety of oral dofetilide for rhythm control of atrial fibrillation and atrial flutter. Circ Arrhythm Electrophysiol. 2015;8:772–776. - PubMed
    1. Kaufman ES, Zimmermann PA, Wang T, et al. Risk of proarrhythmic events in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study: a multivariate analysis. J Am Coll Cardiol. 2004;44:1276–1282. - PubMed
    1. Yarlagadda B, Vuddanda V, Dar T, et al. Safety and efficacy of inpatient initiation of dofetilide versus sotalol for atrial fibrillation. J Atr Fibrillation. 2017;10:1805. - PMC - PubMed
    1. Torp-Pedersen C, Møller M, Bloch-Thomsen PE, et al. Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group. N Engl J Med. 1999;341:857–865. - PubMed

Antiarrhythmic Drug Follow-Up

    1. Ylli D, Wartofsky L, Burman KD. Evaluation and treatment of amiodarone-induced thyroid disorders. J Clin Endocrinol Metab. 2021;106:226–236. - PubMed
    1. Kinoshita S, Hosomi K, Yokoyama S, et al. Time-to-onset analysis of amiodarone-associated thyroid dysfunction. J Clin Pharm Ther. 2020;45:65–71. - PubMed
    1. Flaharty KK, Chase SL, Yaghsezian HM, et al. Hepatotoxicity associated with amiodarone therapy. Pharmacotherapy. 1989;9:39–44. - PubMed
    1. Hamilton D Sr, Nandkeolyar S, Lan H, et al. Amiodarone: a comprehensive guide for clinicians. Am J Cardiovasc Drugs. 2020;20:549–558. - PubMed
    1. Goldschlager N, Epstein AE, Naccarelli GV, et al. A practical guide for clinicians who treat patients with amiodarone: 2007. Heart Rhythm. 2007;4:1250–1259. - PubMed

Upstream Therapy

    1. Dernellis J, Panaretou M. Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation. Eur Heart J. 2004;25:1100–1107. - PubMed
    1. Schneider MP, Hua TA, Böhm M, et al. Prevention of atrial fibrillation by renin-angiotensin system inhibition a meta-analysis. J Am Coll Cardiol. 2010;55:2299–2307. - PubMed
    1. Healey JS, Baranchuk A, Crystal E, et al. Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis. J Am Coll Cardiol. 2005;45:1832–1839. - PubMed
    1. Ducharme A, Swedberg K, Pfeffer MA, et al. Prevention of atrial fibrillation in patients with symptomatic chronic heart failure by candesartan in the Candesartan in Heart failure: assessment of Reduction in Mortality and morbidity (CHARM) program. Am Heart J. 2006;151:985–991. - PubMed
    1. McMurray JJ, Young JB, Dunlap ME, et al. Relationship of dose of background angiotensin-converting enzyme inhibitor to the benefits of candesartan in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Added trial. Am Heart J. 2006;151:985–991. - PubMed

AF Catheter Ablation

    1. Krittayaphong R, Raungrattanaamporn O, Bhuripanyo K, et al. A randomized clinical trial of the efficacy of radiofrequency catheter ablation and amiodarone in the treatment of symptomatic atrial fibrillation. J Med Assoc Thai. 2003;86(suppl 1):S8–S16. - PubMed
    1. Stabile G, Bertaglia E, Senatore G, et al. Catheter ablation treatment in patients with drug-refractory atrial fibrillation: a prospective, multi-centre, randomized, controlled study (Catheter Ablation for the Cure of Atrial Fibrillation Study). Eur Heart J. 2006;27:216–221. - PubMed
    1. Pappone C, Augello G, Sala S, et al. A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study. J Am Coll Cardiol. 2006;48:2340–2347. - PubMed
    1. Packer DL, Mark DB, Robb RA, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA randomized clinical trial. JAMA. 2019;321:1261–1274. - PMC - PubMed
    1. Oral H, Pappone C, Chugh A, et al. Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med. 2006;354:934–941. - PubMed

Patient Selection

    1. Packer DL, Mark DB, Robb RA, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA randomized clinical trial. JAMA. 2019;321:1261–1274. - PMC - PubMed
    1. Andrade JG, Turgeon RD, Macle L, et al. Cryoablation or drug therapy for initial treatment of atrial fibrillation. Eur Cardiol. 2022;17:e10. - PMC - PubMed
    1. Calkins H, Reynolds MR, Spector P, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2:349–361. - PubMed
    1. Blomstrom-Lundqvist C, Gizurarson S, Schwieler J, et al. Effect of catheter ablation vs antiarrhythmic medication on quality of life in patients with atrial fibrillation: the CAPTAF randomized clinical trial. JAMA. 2019;321:1059–1068. - PMC - PubMed
    1. Kirchhof P, Camm AJ, Goette A, et al. Early rhythm-control therapy in patients with atrial fibrillation. N Engl J Med. 2020;383:1305–1316. - PubMed

Techniques and Technologies for AF Catheter Ablation

    1. Atienza F, Almendral J, Ormaetxe JM, et al. Comparison of radiofrequency catheter ablation of drivers and circumferential pulmonary vein isolation in atrial fibrillation: a noninferiority randomized multicenter RADAR-AF trial. J Am Coll Cardiol. 2014;64:2455–2467. - PubMed
    1. Chen M, Yang B, Chen H, et al. Randomized comparison between pulmonary vein antral isolation versus complex fractionated electrogram ablation for paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22:973–981. - PubMed
    1. Di Biase L, Elayi CS, Fahmy TS, et al. Atrial fibrillation ablation strategies for paroxysmal patients: randomized comparison between different techniques. Circ Arrhythm Electrophysiol. 2009;2:113–119. - PubMed
    1. Katritsis DG, Pokushalov E, Romanov A, et al. Autonomic denervation added to pulmonary vein isolation for paroxysmal atrial fibrillation: a randomized clinical trial. J Am Coll Cardiol. 2013;62:2318–2325. - PubMed
    1. Mamchur SE, Mamchur IN, Khomenko EA, et al. 'Electrical exclusion' of a critical myocardial mass by extended pulmonary vein antrum isolation for persistent atrial fibrillation treatment. Interv Med Appl Sci. 2014;6:31–39. - PMC - PubMed

Management of Recurrent AF After Catheter Ablation

    1. Packer DL, Mark DB, Robb RA, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA randomized clinical trial. JAMA. 2019;321:1261–1274. - PMC - PubMed
    1. Kuck KH, Fürnkranz A, Chun KR, et al. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial. Eur Heart J. 2016;37:2858–2865. - PMC - PubMed
    1. Piccini JP, Sinner MF, Greiner MA, et al. Outcomes of Medicare beneficiaries undergoing catheter ablation for atrial fibrillation. Circulation. 2012;126:2200–2207. - PMC - PubMed
    1. Wokhlu A, Monahan KH, Hodge DO, et al. Long-term quality of life after ablation of atrial fibrillation the impact of recurrence, symptom relief, and placebo effect. J Am Coll Cardiol. 2010;55:2308–2316. - PubMed
    1. Calkins H, Reynolds MR, Spector P, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2:349–361. - PubMed

Anticoagulation Therapy Before and After Catheter Ablation

    1. Di Biase L, Gaita F, Toso E, et al. Does periprocedural anticoagulation management of atrial fibrillation affect the prevalence of silent thromboembolic lesion detected by diffusion cerebral magnetic resonance imaging in patients undergoing radiofrequency atrial fibrillation ablation with open irrigated catheters? Results from a prospective multicenter study. Heart Rhythm. 2014;11:791–798. - PubMed
    1. Cardoso R, Knijnik L, Bhonsale A, et al. An updated meta-analysis of novel oral anticoagulants versus vitamin K antagonists for uninterrupted anticoagulation in atrial fibrillation catheter ablation. Heart Rhythm. 2018;15:107–115. - PubMed
    1. Kirchhof P, Haeusler KG, Blank B, et al. Apixaban in patients at risk of stroke undergoing atrial fibrillation ablation. Eur Heart J. 2018;39:2942–2955. - PMC - PubMed
    1. Kuwahara T, Abe M, Yamaki M, et al. Apixaban versus warfarin for the prevention of periprocedural cerebral thromboembolism in atrial fibrillation ablation: multicenter prospective randomized study. J Cardiovasc Electrophysiol. 2016;27:549–554. - PubMed
    1. Calkins H, Willems S, Gerstenfeld EP, et al. Uninterrupted dabigatran versus warfarin for ablation in atrial fibrillation. N Engl J Med. 2017;376:1627–1636. - PubMed

Complications After AF Catheter Ablation

    1. Deshmukh A, Patel NJ, Pant S, et al. In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010: analysis of 93 801 procedures. Circulation. 2013;128:2104–2112. - PubMed
    1. Steinbeck G, Sinner MF, Lutz M, et al. Incidence of complications related to catheter ablation of atrial fibrillation and atrial flutter: a nationwide in-hospital analysis of administrative data for Germany in 2014. Eur Heart J. 2018;39:4020–4029. - PMC - PubMed
    1. Loring Z, Holmes DN, Matsouaka RA, et al. Procedural patterns and safety of atrial fibrillation ablation: findings from Get With The Guidelines-Atrial Fibrillation. Circ Arrhythm Electrophysiol. 2020;13:e007944. - PMC - PubMed
    1. Campbell ML, Larson J, Farid T, et al. Sex-based differences in procedural complications associated with atrial fibrillation catheter ablation: a systematic review and meta-analysis. J Cardiovasc Electrophysiol. 2020;31:3176–3186. - PubMed
    1. Russo AM, Zeitler EP, Giczewska A, et al. Association between sex and treatment outcomes of atrial fibrillation ablation versus drug therapy: results from the CABANA trial. Circulation. 2021;143:661–672. - PMC - PubMed

Role of Pacemakers and ICDs for the Prevention and Treatment of AF

    1. Stambler BS, Ellenbogen KA, Orav EJ, et al. Predictors and clinical impact of atrial fibrillation after pacemaker implantation in elderly patients treated with dual chamber versus ventricular pacing. Pacing Clin Electrophysiol. 2003;26:2000–2007. - PubMed
    1. Skanes AC, Krahn AD, Yee R, et al. Progression to chronic atrial fibrillation after pacing: the Canadian Trial of Physiologic Pacing. CTOPP Investigators. J Am Coll Cardiol. 2001;38:167–172. - PubMed
    1. Hesselson AB, Parsonnet V, Bernstein AD, et al. Deleterious effects of long-term single-chamber ventricular pacing in patients with sick sinus syndrome: the hidden benefits of dual-chamber pacing. J Am Coll Cardiol. 1992;19:1542–1549. - PubMed
    1. Andersen HR, Nielsen JC, Thomsen PE, et al. Long-term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sicksinus syndrome. Lancet. 1997;350:1210–1216. - PubMed
    1. Lamas GA, Lee KL, Sweeney MO, et al. Ventricular pacing or dual-chamber pacing for sinus node dysfunction. N Engl J Med. 2002;346:1854–1862. - PubMed

Surgical Ablation

    1. Huffman MD, Malaisrie SC, Karmali KN. Concomitant atrial fibrillation surgery for people undergoing cardiac surgery. JAMA Cardiol. 2017;2:334–335. - PubMed
    1. Huffman MD, Karmali KN, Berendsen MA, et al. Concomitant atrial fibrillation surgery for people undergoing cardiac surgery. Cochrane Database Syst Rev. 2016;8:CD011814. - PMC - PubMed
    1. Gillinov M, Moskowitz AJ, Argenziano M. Surgical ablation for atrial fibrillation. N Engl J Med. 2015;373:484. - PubMed
    1. Noseworthy PA, Yao X, Deshmukh AJ, et al. Patterns of anticoagulation use and cardioembolic risk after catheter ablation for atrial fibrillation. J Am Heart Assoc. 2015;4:e002597. - PMC - PubMed
    1. Kress DC, Erickson L, Choudhuri I, et al. Comparative effectiveness of hybrid ablation versus endocardial catheter ablation alone in patients with persistent atrial fibrillation. JACC Clin Electrophysiol. 2017;3:341–349. - PubMed

General Considerations for AF and HF

    1. Melenovsky V, Hwang SJ, Redfield MM, et al. Left atrial remodeling and function in advanced heart failure with preserved or reduced ejection fraction. Circ Heart Fail. 2015;8:295–303. - PubMed
    1. Tsang TS, Gersh BJ, Appleton CP, et al. Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women. J Am Coll Cardiol. 2002;40:1636–1644. - PubMed
    1. Rosenberg MA, Gottdiener JS, Heckbert SR, et al. Echocardiographic diastolic parameters and risk of atrial fibrillation: the Cardiovascular Health Study. Eur Heart J. 2012;33:904–912. - PMC - PubMed
    1. Ariyaratnam JP, Lau DH, Sanders P, et al. Atrial fibrillation and heart failure: epidemiology, pathophysiology, prognosis, and management. Card Electrophysiol Clin. 2021;13:47–62. - PubMed
    1. Santhanakrishnan R, Wang N, Larson MG, et al. Atrial fibrillation begets heart failure and vice versa: temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016;133:484–492. - PMC - PubMed

Management of AF in Patients With HF

    1. Rillig A, Magnussen C, Ozga AK, et al. Early rhythm control therapy in patients with atrial fibrillation and heart failure. Circulation. 2021;144:845–858. - PMC - PubMed
    1. Brachmann J, Sohns C, Andresen D, et al. Atrial fibrillation burden and clinical outcomes in heart failure: the CASTLE-AF trial. JACC Clin Electrophysiol. 2021;7:594–603. - PubMed
    1. Chen S, Pürerfellner H, Meyer C, et al. Rhythm control for patients with atrial fibrillation complicated with heart failure in the contemporary era of catheter ablation: a stratified pooled analysis of randomized data. Eur Heart J. 2020;41:2863–2873. - PubMed
    1. Di Biase L, Mohanty P, Mohanty S, et al. Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: results from the AATAC multicenter randomized trial. Circulation. 2016;133:1637–1644. - PubMed
    1. Hunter RJ, Berriman TJ, Diab I, et al. A randomized controlled trial of catheter ablation versus medical treatment of atrial fibrillation in heart failure (the CAMTAF trial). Circ Arrhythm Electrophysiol. 2014;7:31–38. - PubMed

Management of Early Onset AF, Including Genetic Testing

    1. Yalin K, Ikitimur B, Aksu T, et al. Catheter ablation for atrial fibrillation in patients </=30 years of age. Am J Cardiol. 2022;166:53–57. - PubMed
    1. Ceresnak SR, Liberman L, Silver ES, et al. Lone atrial fibrillation in the young - perhaps not so “lone”? J Pediatr. 2013;162:827–831. - PubMed
    1. Sauer WH, Alonso C, Zado E, et al. Atrioventricular nodal reentrant tachycardia in patients referred for atrial fibrillation ablation: response to ablation that incorporates slow-pathway modification. Circulation. 2006;114:191–195. - PubMed
    1. Yoneda ZT, Anderson KC, Quintana JA, et al. Early-onset atrial fibrillation and the prevalence of rare variants in cardiomyopathy and arrhythmia genes. JAMA Cardiol. 2021;6:1371–1379. - PMC - PubMed
    1. Goodyer WR, Dunn K, Caleshu C, et al. Broad genetic testing in a clinical setting uncovers a high prevalence of titin loss-of-function variants in very early onset atrial fibrillation. Circ Genom Precis Med. 2019;12:e002713. - PMC - PubMed

Athletes

    1. Mandsager KT, Phelan DM, Diab M, et al. Outcomes of pulmonary vein isolation in athletes. JACC Clin Electrophysiol. 2020;6:1265–1274. - PubMed
    1. Toso E, Gagliardi M, Peyracchia M, et al. Long-term efficacy and impact on quality of life of atrial fibrillation catheter ablation in competitive athletes. J Sports Med Phys Fitness. 2022;62:1266–1271. - PubMed
    1. Azarbal F, Stefanick ML, Salmoirago-Blotcher E, et al. Obesity, physical activity, and their interaction in incident atrial fibrillation in postmenopausal women. J Am Heart Assoc. 2014;3:e001127. - PMC - PubMed
    1. Mozaffarian D, Furberg CD, Psaty BM, et al. Physical activity and incidence of atrial fibrillation in older adults: the cardiovascular health study. Circulation. 2008;118:800–807. - PMC - PubMed
    1. Newman W, Parry-Williams G, Wiles J, et al. Risk of atrial fibrillation in athletes: a systematic review and meta-analysis. Br J Sports Med. 2021;55:1233–1238. - PubMed

Management Considerations in Patients With AF and Obesity

    1. Chung MK, Eckhardt LL, Chen LY, et al. Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association. Circulation. 2020;141:e750–e772. - PubMed
    1. Wang TJ, Parise H, Levy D, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292:2471–2477. - PubMed
    1. Wong CX, Sun MT, Odutayo A, et al. Associations of Epicardial, abdominal, and overall adiposity with atrial fibrillation. Circ Arrhythm Electrophysiol. 2016;9:e004378. - PubMed
    1. Wong CX, Sullivan T, Sun MT, et al. Obesity and the risk of incident, postoperative, and post-ablation atrial fibrillation: a meta-analysis of 626 603 individuals in 51 studies. JACC Clin Electrophysiol. 2015;1:139–152. - PubMed

Anticoagulation Considerations in Patients With Class III Obesity

    1. Barakat AF, Jain S, Masri A, et al. Outcomes of direct oral anticoagulants in atrial fibrillation patients across different body mass index categories. JACC Clin Electrophysiol. 2021;7:649–658. - PubMed
    1. Malik AH, Yandrapalli S, Shetty S, et al. Impact of weight on the efficacy and safety of direct-acting oral anticoagulants in patients with non-valvular atrial fibrillation: a meta-analysis. Europace. 2020;22:361–367. - PubMed
    1. Hohnloser SH, Fudim M, Alexander JH, et al. Efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation and extremes in body weight. Circulation. 2019;139:2292–2300. - PubMed
    1. Boriani G, Ruff CT, Kuder JF, et al. Relationship between body mass index and outcomes in patients with atrial fibrillation treated with edoxaban or warfarin in the ENGAGE AF-TIMI 48 trial. Eur Heart J. 2019;40:1541–1550. - PubMed
    1. Balla SR, Cyr DD, Lokhnygina Y, et al. Relation of risk of stroke in patients with atrial fibrillation to body mass index (from patients treated with rivaroxaban and warfarin in the rivaroxaban once daily oral direct factor Xa inhibition compared with vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation Trial). Am J Cardiol. 2017;119:1989–1996. - PubMed

AF and VHD

    1. Petty GW, Khandheria BK, Whisnant JP, et al. Predictors of cerebrovascular events and death among patients with valvular heart disease: a population-based study. Stroke. 2000;31:2628–2635. - PubMed

WPW and Preexcitation Syndromes

    1. Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133:e506–e574. - PubMed
    1. Roth A, Elkayam I, Shapira I, et al. Effectiveness of prehospital synchronous direct-current cardioversion for supraventricular tachyarrhythmias causing unstable hemodynamic states. Am J Cardiol. 2003;91:489–491. - PubMed
    1. Pappone C, Vicedomini G, Manguso F, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation. 2014;130:811–819. - PubMed
    1. Kugler JD, Danford DA, Houston K, et al. Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia in children and adolescents without structural heart disease Pediatric EP Society, Radiofrequency Catheter Ablation Registry. Am J Cardiol. 1997;80:1438–1443. - PubMed
    1. Calkins H, Langberg J, Sousa J, et al. Radiofrequency catheter ablation of accessory atrioventricular connections in 250 patients Abbreviated therapeutic approach to Wolff-Parkinson-White syndrome. Circulation. 1992;85:1337–1346. - PubMed

Hypertrophic Cardiomyopathy (HCM)

    1. Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142:e558–e631. - PubMed
    1. Guttmann OP, Rahman MS, O'Mahony C, et al. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart. 2014;100:465–472. - PubMed
    1. Kubo T, Baba Y, Ochi Y, et al. Clinical significance of new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy. ESC Heart Fail. 2021;8:5022–5030. - PMC - PubMed
    1. Fauchier L, Bisson A, Bodin A, et al. Ischemic stroke in patients with hypertrophic cardiomyopathy according to presence or absence of atrial fibrillation. Stroke. 2022;53:497–504. - PubMed
    1. Alphonse P, Virk S, Collins J, et al. Prognostic impact of atrial fibrillation in hypertrophic cardiomyopathy: a systematic review. Clin Res Cardiol. 2021;110:544–554. - PubMed

Adult Congenital Heart Disease (ACHD)

    1. Escudero C, Khairy P, Sanatani S. Electrophysiologic considerations in congenital heart disease and their relationship to heart failure. Can J Cardiol. 2013;29:821–829. - PubMed
    1. Miyazaki A, Negishi J, Hayama Y, et al. Etiology of atrial fibrillation in patients with complex congenital heart disease - for a better treatment strategy. J Cardiol. 2020;76:438–445. - PubMed
    1. Mylotte D, Pilote L, Ionescu-Ittu R, et al. Specialized adult congenital heart disease care: the impact of policy on mortality. Circulation. 2014;129:1804–1812. - PubMed
    1. Liang JJ, Frankel DS, Parikh V, et al. Safety and outcomes of catheter ablation for atrial fibrillation in adults with congenital heart disease: a multicenter registry study. Heart Rhythm. 2019;16:846–852. - PubMed
    1. Fischer AJ, Enders D, Wasmer K, et al. Impact of specialized electrophysiological care on the outcome of catheter ablation for supraventricular tachycardias in adults with congenital heart disease: independent risk factors and gender aspects. Heart Rhythm. 2021;18:1852–1859. - PubMed

Prevention of AF After Cardiac Surgery

    1. Filardo G, da Graca B, Sass DM, et al. Preoperative β-blockers as a coronary surgery quality metric: the lack of evidence of efficacy. Ann Thorac Surg. 2020;109:1150–1158. - PubMed
    1. Gillinov AM, Bagiella E, Moskowitz AJ, et al. Rate control versus rhythm control for atrial fibrillation after cardiac surgery. N Engl J Med. 2016;374:1911–1921. - PMC - PubMed
    1. Mehaffey JH, Hawkins RB, Byler M, et al. Amiodarone protocol provides cost-effective reduction in postoperative atrial fibrillation. Ann Thorac Surg. 2018;105:1697–1702. - PMC - PubMed
    1. Guarnieri T Intravenous antiarrhythmic regimens with focus on amiodarone for prophylaxis of atrial fibrillation after open heart surgery. Am J Cardiol. 1999;84:152r–155r. - PubMed
    1. Mitchell LB, Exner DV, Wyse DG, et al. Prophylactic oral amiodarone for the prevention of arrhythmias that begin early after revascularization, valve replacement, or repair: PAPABEAR: a randomized controlled trial. JAMA. 2005;294:3093–3100. - PubMed

Treatment of AF After Cardiac Surgery

    1. Filardo G, da Graca B, Sass DM, et al. Preoperative β-blockers as a coronary surgery quality metric: the lack of evidence of efficacy. Ann Thorac Surg. 2020;109:1150–1158. - PubMed
    1. Arsenault KA, Yusuf AM, Crystal E, et al. Interventions for preventing postoperative atrial fibrillation in patients undergoing heart surgery. Cochrane Database Syst Rev. 2013;2013:Cd003611. - PMC - PubMed
    1. Brinkman W, Herbert MA, O'Brien S, et al. Preoperative beta-blocker use in coronary artery bypass grafting surgery: national database analysis. JAMA Intern Med. 2014;174:1320–1327. - PubMed
    1. Kohsaka S, Miyata H, Motomura N, et al. Effects of preoperative beta-blocker use on clinical outcomes after coronary artery bypass grafting: a report from the Japanese Cardiovascular Surgery Database. Anesthesiology. 2016;124:45–55. - PubMed
    1. Gillinov AM, Bagiella E, Moskowitz AJ, et al. Rate control versus rhythm control for atrial fibrillation after cardiac surgery. N Engl J Med. 2016;374:1911–1921. - PMC - PubMed

Acute Medical Illness or Surgery (Including AF in Critical Care)

    1. McIntyre WF, Um KJ, Cheung CC, et al. Atrial fibrillation detected initially during acute medical illness: a systematic review. Eur Heart J. 2019;8:130–141. - PubMed
    1. Lubitz SA, Yin X, Rienstra M, et al. Long-term outcomes of secondary atrial fibrillation in the community: the Framingham Heart Study. Circulation. 2015;131:1648–1655. - PMC - PubMed
    1. Wang EY, Hulme OL, Khurshid S, et al. Initial precipitants and recurrence of atrial fibrillation. Circ Arrhythm Electrophysiol. 2020;13:e007716. - PMC - PubMed
    1. Abdelmoneim SS, Rosenberg E, Meykler M, et al. The incidence and natural progression of new-onset postoperative atrial fibrillation. JACC Clin Electrophysiol. 2021;7:1134–1144. - PubMed
    1. Charitos EI, Herrmann FEM, Ziegler PD. Atrial fibrillation recurrence and spontaneous conversion to sinus rhythm after cardiac surgery: insights from 426 patients with continuous rhythm monitoring. J Cardiovasc Electrophysiol. 2021;32:2171–2178. - PubMed

Hyperthyroidism

    1. Gundlund A, Kumler T, Bonde AN, et al. Comparative thromboembolic risk in atrial fibrillation with and without a secondary precipitant-Danish nationwide cohort study. BMJ Open. 2019;9:e028468. - PMC - PubMed
    1. Tng EL, Tiong YS, Aung AT, et al. Efficacy and safety of anticoagulation in thyrotoxic atrial fibrillation: a systematic review and meta-analysis. Endocr Connect. 2022;11:e220166. - PMC - PubMed
    1. Jabbar A, Pingitore A, Pearce SH, et al. Thyroid hormones and cardiovascular disease. Nat Rev Cardiol. 2017;14:39–55. - PubMed
    1. Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87:489–499. - PubMed
    1. Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study. Arch Intern Med. 2004;164:1675–1678. - PubMed

Pulmonary Disease

    1. Du Q, Sun Y, Ding N, et al. Beta-blockers reduced the risk of mortality and exacerbation in patients with COPD: a meta-analysis of observational studies. PLoS One. 2014;9:e113048. - PMC - PubMed
    1. Salpeter S, Ormiston T, Salpeter E. Cardioselective beta-blockers for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2005;4:CD003566. - PMC - PubMed
    1. Dransfield MT, Voelker H, Bhatt SP, et al. Metoprolol for the prevention of acute exacerbations of COPD. N Engl J Med. 2019;381:2304–2314. - PMC - PubMed
    1. Tongers J, Schwerdtfeger B, Klein G, et al. Incidence and clinical relevance of supraventricular tachyarrhythmias in pulmonary hypertension. Am Heart J. 2007;153:127–132. - PubMed
    1. Showkathali R, Tayebjee MH, Grapsa J, et al. Right atrial flutter isthmus ablation is feasible and results in acute clinical improvement in patients with persistent atrial flutter and severe pulmonary arterial hypertension. Int J Cardiol. 2011;149:279–280. - PubMed

Pregnancy

    1. Georgiopoulos G, Tsiachris D, Kordalis A, et al. Pharmacotherapeutic strategies for atrial fibrillation in pregnancy. Expert Opin Pharmacother. 2019;20:1625–1636. - PubMed
    1. Tamirisa KP, Elkayam U, Briller JE, et al. Arrhythmias in pregnancy. JACC Clin Electrophysiol. 2022;8:120–135. - PubMed
    1. van Hagen IM, Roos-Hesselink JW, Ruys TP, et al. Pregnancy in women with a mechanical heart valve: data of the European Society of Cardiology Registry of Pregnancy and Cardiac Disease (ROPAC). Circulation. 2015;132:132–142. - PubMed
    1. Vaidya VR, Arora S, Patel N, et al. Burden of arrhythmia in pregnancy. Circulation. 2017;135:619–621. - PubMed
    1. Salam AM, Ertekin E, van Hagen IM, et al. Atrial fibrillation or flutter during pregnancy in patients with structural heart disease: data from the ROPAC (Registry on Pregnancy and Cardiac Disease). JACC Clin Electrophysiol. 2015;1:284–292. - PubMed

Cardio-Oncology and Anticoagulation Considerations

    1. Beavers CJ, Rodgers JE, Bagnola AJ, et al. Cardio-oncology drug interactions: a scientific statement from the American Heart Association. Circulation. 2022;145:e811–e838. - PubMed
    1. van Leeuwen RWF, Jansman FGA, van den Bemt P, et al. Drug-drug interactions in patients treated for cancer: a prospective study on clinical interventions. Ann Oncol. 2015;26:992–997. - PubMed
    1. Kim PY, Irizarry-Caro JA, Ramesh T, et al. How to diagnose and manage QT prolongation in cancer patients. JACC CardioOncol. 2021;3:145–149. - PMC - PubMed
    1. Ye JZ, Hansen FB, Mills RW, et al. Oncotherapeutic protein kinase inhibitors associated with pro-arrhythmic liability. JACC CardioOncol. 2021;3:88–97. - PMC - PubMed
    1. O'Neal WT, Lakoski SG, Qureshi W, et al. Relation between cancer and atrial fibrillation (from the REasons for Geographic And Racial Differences in Stroke Study). Am J Cardiol. 2015;115:1090–1094. - PMC - PubMed

CKD and Kidney Failure

    1. Alonso A, Lopez FL, Matsushita K, et al. Chronic kidney disease is associated with the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2011;123:2946–2953. - PMC - PubMed
    1. Watanabe H, Watanabe T, Sasaki S, et al. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J. 2009;158:629–636. - PubMed
    1. Bansal N, Fan D, Hsu CY, et al. Incident atrial fibrillation and risk of end-stage renal disease in adults with chronic kidney disease. Circulation. 2013;127:569–574. - PMC - PubMed

Anticoagulation Use in Patients With Liver Disease

    1. Qamar A, Antman EM, Ruff CT, et al. Edoxaban versus warfarin in patients with atrial fibrillation and history of liver disease. J Am Coll Cardiol. 2019;74:179–189. - PubMed
    1. Serper M, Weinberg EM, Cohen JB, et al. Mortality and hepatic decompensation in patients with cirrhosis and atrial fibrillation treated with anticoagulation. Hepatology. 2021;73:219–232. - PMC - PubMed
    1. Proietti M, Marzona I, Vannini T, et al. Impact of liver disease on oral anticoagulant prescription and major adverse events in patients with atrial fibrillation: analysis from a population-based cohort study. Eur Heart J Cardiovasc Pharmacother. 2021;7:f84–f92. - PubMed
    1. Pastori D, Lip GYH, Farcomeni A, et al. Incidence of bleeding in patients with atrial fibrillation and advanced liver fibrosis on treatment with vitamin K or non-vitamin K antagonist oral anticoagulants. Int J Cardiol. 2018;264:58–63. - PubMed
    1. Pastori D, Sciacqua A, Marcucci R, et al. Prevalence and impact of nonalcoholic fatty liver disease in atrial fibrillation. Mayo Clin Proc. 2020;95:513–520. - PubMed

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