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New 2016 European Society of Cardiology/European Association for Cardio-Thoracic Surgery Guidelines.

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eMediNexus    02 April 2018

A new article published in the European Journal of Cardio-thoracic Surgery reported on consensus guidelines for the management of atrial fibrillation (AF) developed by the collaborating European Society of Cardiology and the European Association for Cardio-Thoracic Surgery. It was stated that one of the main issues is the integrated care of patients with AF, which essentiates multidisciplinary teams of general physicians, cardiologists, stroke specialists and surgeons, along with the patients involvement for better management of AF. The article described that these guidelines help in the detection of risk factors and concomitant cardiovascular diseases, stroke prevention therapies, including anticoagulation and antiplatelet therapies after acute coronary episodes, major hemorrhages or strokes. It was further discussed that surgery plays an important role in the field of ablation and should be considered in symptomatic patients with high level of evidence. Meanwhile, asymptomatic patients with mitral insufficiency should also be considered for combined mitral and AF surgery, in the case of new-onset AF. On the other hand, in patients with stand-alone AF, recommendations for minimally invasive ablation have an increased level of recommendation and should be considered as the same level as catheter ablation in patients with persistent or long-standing persistent AF or with paroxysmal AF who fail catheter ablation. While surgical occlusion or exclusion of the left atrial appendage may be considered for stroke prevention in patients with AF about to have surgery. In summary, it was stated that these guidelines provide a full spectrum of recommendations on the management of patients with AF including prevention, treatment and complications based on the latest published evidence.

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