New clinical practice guidelines for atrial fibrillation from ESC

3 Sept 2010

The European Society of Cardiology (ESC) has released of new Clinical Practice Guidelines covering atrial fibrillation. These are the first guidelines to be prepared solely by the ESC on this very important topic.

Earlier guidelines on atrial fibrillation had been prepared collaboratively with the American Heart Association and the American College of Cardiology, but the divergence in practice, drug treatments and the regulatory environment compared with the US have now made it vital to create a European-specific version. The new guidelines were presented at the annual ESC Congress in Stockholm last week.

Atrial Fibrillation is the most common cardiac arrhythmia condition, affecting over six million Europeans. The main symptom is that, instead of a co-ordinated contraction of the two upper chambers of the heart (the atria), the atrial muscle is activated too quickly and simply quivers instead of contracting. Patients experience palpitations and other symptoms such as breathlessness and fatigue. The condition confers a five-fold increase in the risk of a stroke if left untreated, and then a doubling of the risk of death from that stroke.

The Guidelines reflect notable developments in many of the conventional treatments for the condition as well as the very latest techniques to manage it:

  • Rate control strategies for patients with permanent atrial fibrillation;
  • New risk profiling to identify patients at risk of stroke;
  • Availability of arrhythmic drugs with fewer side-effects;
  • More specific indications for the use of ablation treatment;
  • Upstream therapies that can halt the progression of the condition.

Professor John Camm of the University of London is a renowned international expert on arrhythmia, and he is also a Fellow of the European Society of Cardiology. He was appointed Chair of the ESC Task Force that developed the highly detailed Clinical Practice Guidelines. “Atrial Fibrillation has become an epidemic, and we estimate that around 1-2% of the total population are affected,” he said.

“This figure is expected to at least double in line with the demographics of an ageing population because it is particularly prevalent amongst older people. We needed to create up-to-date guidelines because of new drug therapies available, and also because accumulated evidence continuously refines the advice on treatment regimens that give the best outcomes.”

About ESC guidelines

ESC Clinical Practice Guidelines are scientifically recognised worldwide as providing practicing physicians with the best possible recommendations on diagnosis, treatment and management of specific topics in cardiology medicine. Guidelines are created and edited under the umbrella of the ESC Board and the Committee for Practice Guidelines (CPG), who form a Task Force of appropriate experts from the ESC Associations, Working Groups, Councils, and National Societies, and from other bodies when required. They are the result of consensus amongst the Task Force appointed to prepare them, and they are peer-reviewed in a thorough and rigorous process that ensures accuracy, best-practice and relevance. Guidelines are available in a variety of printed and electronic media and in multiple formats including full documents, pocket guides and summaries.

The complete Atrial Fibrillation Guidelines can be downloaded from the ESC website at:


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