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Can J Cardiol. 2018 Nov;34(11):1371-1392. doi: 10.1016/j.cjca.2018.08.026.

2018 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation.

Author information

1
University of British Columbia, Vancouver, British Columbia, Canada; Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
2
Southlake Regional Health Centre, Newmarket, Ontario, Canada.
3
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
4
QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
5
University Health Network, University of Toronto, Toronto, Ontario, Canada.
6
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
7
McMaster University, Hamilton, Ontario, Canada; Hamilton General Hospital, Hamilton, Ontario, Canada.
8
University of Toronto, Toronto, Ontario, Canada.
9
University of British Columbia, Vancouver, British Columbia, Canada.
10
St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
11
University of Alberta, Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
12
University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
13
McGill University Health Centre, Montréal, Quebec, Canada.
14
Institut universitaire de cardiologie et pneumologie, Quebec, Quebec, Canada.
15
London Heart Institute, Western University, London, Ontario, Canada.
16
Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
17
Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada. Electronic address: lmacle@mac.com.

Abstract

The Canadian Cardiovascular Society (CCS) Atrial Fibrillation Guidelines Committee provides periodic reviews of new data to produce focused updates that address clinically important advances in atrial fibrillation (AF) management. This 2018 Focused Update addresses: (1) anticoagulation in the context of cardioversion of AF; (2) the management of antithrombotic therapy for patients with AF in the context of coronary artery disease; (3) investigation and management of subclinical AF; (4) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (5) acute pharmacological cardioversion of AF; (6) catheter ablation for AF, including patients with concomitant AF and heart failure; and (7) an integrated approach to the patient with AF and modifiable cardiovascular risk factors. The recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) standards. Individual studies and literature were reviewed for quality and bias; the literature review process and evidence tables are included as Supplementary Material and are available on the CCS Web site. Details of the updated recommendations are presented, along with their background and rationale. This document is linked to an updated summary of all CCS AF guidelines recommendations, from 2010 to the present 2018 Focused Update, which is provided in the Supplementary Material.

PMID:
30404743
DOI:
10.1016/j.cjca.2018.08.026

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