Atrial fibrillation affects millions of patients, and its incidence and prevalence are on the rise. It’s a peculiar disease in that it affects people so differently. When populations are studied, AF associates with higher rates of stroke, heart failure and death. But patients aren’t populations.
In recent years, the treatment options for this pesky disease have expanded. This is both good news and bad news. The good news is that when these treatments are applied wisely, with an engaged patient, outcomes can be improved. As an AF caregiver, it is gratifying to use these tools to help people. The bad news is that AF treatment can be worse than the disease. The greatest challenge in trying to help patients with AF is to do so without making them worse. AF treatment is not easy. Not even close. The act of treating AF marches both patient and caregiver right up to the edge–of doing harm.
Specialists in atrial fibrillation treat only a small fraction of the millions of patients with AF. Primary care doctors and general cardiologists treat the majority. This is why the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation is so important. The 123-page document lays out the most comprehensive and up-to-date information about the disease. The writing committee had a daunting task. The evidence base for AF is enormous. Getting it into a readable concise document was no small task.
I’m pleased to announce that the writers succeeded. I really liked the new guidelines. The writers mostly avoided telling us what to do. Instead, they wrote concisely and clearly about the evidence. They emphasized patient preferences and shared decisions. They weren’t perfect in removing paternalism but they took a major step forward.
Before heading out on vacation, I read all 123 pages of this document. I jotted down notes and put them together into a post–which was part reporting and part editorial. The post went up today on theHeart.org | Medscape/Cardiology.
I hope you want to read my summary. It’s written for a physician audience so there is some medical speak. I broke it down into ten notable categories, each with 1-2 paragraphs. Big categories got bulleted lists. I concluded with one criticism.
Here is the link and title of my post: 2014 AF Treatment Guidelines: 10 Things to Like and Only One to Dislike