National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Diagnosis and Management of Atrial Fibrillation 2018
NHFA CSANZ Atrial Fibrillation Guideline Working Group, Brieger, D., Amerena, J., Attia, J., Bajorek, B., Chan, K. H., Connell, C., Freedman, B., Ferguson, C., Hall, T., Haqqani, H., Hendriks, J., Hespe, C., Hung, J., Kalman, J. M., Sanders, P., Worthington, J., Yan, T. D., & Zwar, N. (2018). National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Diagnosis and Management of Atrial Fibrillation 2018. Heart Lung and Circulation, 27 (10), 1209-1266.
Rationale for these Guidelines
In 2015, the National Heart Foundation of Australia (NHFA) and the Cardiac Society of Australia and New Zealand (CSANZ) undertook a survey of emerging issues in cardiovascular disease. The goal was to prioritise clinical conditions that would benefit from locally developed contemporary guidelines. Individual diseases were evaluated according to burden of disease, the existence of treatment gaps, an evolving therapeutic landscape, evidence of inequity and the existence of local treatment guidelines. Atrial fibrillation (AF) scored highly in each of these categories. Specifically, AF was recognised as a burdensome condition with increasing prevalence, where large numbers of patients are not treated with anticoagulation, despite the clear benefit of this therapy in stroke prevention. Other factors relevant to AF were: _
- the relatively recent availability of non-vitamin K oral anticoagulants (NOACs), with a rapidly evolving evidence base guiding their use;
- variation and uncertainty about best practice use of anti-arrhythmic drugs
- increasing availability of AF ablative procedures;
- an increasing prevalence of AF in older people and Aboriginal and Torres Strait Islander peoples.
International guidelines on the diagnosis and management of AF are available, but these often differ from each other with regards to individual recommendations, and no such guidelines had been developed specific to the Australian population. Therefore, NHFA and CSANZ resolved to produce Australian guidelines for AF.
These clinical guidelines have been developed to assist Australian practitioners in the management of adult patients with AF. They are intended to be used by practising clinicians across all disciplines caring for such patients. Some of the core recommendations of this document have been informed by existing international guidelines, including the 2016 European Society of Cardiology Guide- lines for the management of atrial fibrillation, which were developed in collaboration with the European Association for Cardio-Thoracic Surgery, and the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society Guideline for the management of patients with atrial fibrillation. However, these Australian guide- lines provide a focus on local practice and include some updated recommendations reflecting more recent evidence generation.
cardiovasular disease, atrial fibrillation, clinical guidelines, Australia, New Zealand