Atrial Fibrillation

Evidence Based Reports

Thoracoscopic exclusion of the left atrial appendage (with or without surgical ablation) for non-valvular atrial fibrillation for the prevention of thromboembolism (2011)[NICE] NEW

Percutaneous endoscopic catheter laser balloon pulmonary vein isolation for atrial fibrillation (2011)[NICE] NEW

Effect of statins on atrial fibrillation: collaborative meta-analysis of published and unpublished evidence from randomised controlled trials (2011)[DARE] NEW

Cost effectiveness of warfarin versus aspirin in patients older than 75 years with atrial fibrillation (2011)[NEED] NEW

Catheter ablation for atrial fibrillation on uninterrupted warfarin: can it be done without echo guidance? (2011)[NEED] NEW

Dronedarone increases the risk of heart failure, stroke and death compared to placebo in people with permanent AF (2011)[MeReC Rapid Review] NEW

Modelling study finds no net benefit from aspirin plus clopidogrel versus aspirin alone in people with AF unable to take warfarin (2011)[MeReC Rapid Review] NEW

Apixaban versus warfarin in atrial fibrillation: the ARISTOTLE study in context (2011)[On the Horizon Rapid Review] NEW

Dabigatran in Atrial Fibrillation (2011)[Northern and Yorkshire Drug and Therapeutics Centre] NEW

Rivaroxaban non-inferior to warfarin for the prevention of stroke or systemic embolism in patients with nonvalvular atrial fibrillation (2011)[On the Horizon Rapid Review] NEW

Dabigatran - for stroke prevention in patients with atrial fibrillation (2011)[MTRAC] NEW

Dronedarone for the treatment of atrial fibrillation (2011)[MTRAC]NEW

Atrial fibrillation (2010)[WeMeReC]

Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism (2010)[NICE]

Dronedarone for the treatment of non-permanent atrial fibrillation (2010)[NICE]

Systematic review and cost effectiveness evaluation of 'pill-in-the-pocket' strategy for paroxysmal atrial fibrillation compared to episodic in-hospital treatment or continuous antiarrhythmic drug therapy (2010)[HTA]

Statins for prevention of atrial fibrillation after cardiac surgery: a systematic literature review (2010)[DARE]

In atrial fibrillation: rate versus rhythm and how slow do you go? (2010)[TFP]

Warfarin vs. Aspirin For Atrial Fibrillation Stroke Prevention (2010)[theNNT]

Warfarin for Atrial Fibrillation Stroke Prevention (2010)[theNNT]

Rivaroxaban (Xarelto) for stroke prevention in atrial fibrillation (2009)[National Horizon Scanning Centre]

Percutaneous (non-thoracoscopic)epicardial catheter radiofrequency ablation for atrial fibrillation (2009)[NICE]

Thoracoscopic epicardial radiofrequency ablation for atrial fibrillation (2009)[NICE]

Comparative effectiveness of radiofrequency catheter ablation for atrial fibrillation(2009)[DARE]

A systematic review of randomized trials comparing radiofrequency ablation with antiarrhythmic medications in patients with atrial fibrillation (2009)[DARE]

Intravenous magnesium sulphate and sotalol for prevention of atrial fibrillation after coronary artery bypass surgery: a systematic review and economic evaluation (2008) [NCCHTA]

Curative catheter ablation in atrial fibrillation and typical atrial flutter: systematic review and economic evaluation (2008)[NCCHTA]

Antiarrhythmic effect of statin therapy and atrial fibrillation: a meta-analysis of randomized controlled trials (2008)[DARE]

Catheter ablation vs antiarrhythmic drug therapy for atrial fibrillation: a systematic review (2008)[DARE]

Dabigatran etexilate (Pradaxa) for stroke prevention in atrial fibrillation (2008)[National Horizon Scanning Centre]

Clopidogrel (Plavix) in combination with aspirin for prevention of vascular events in patients with atrial fibrillation (2008) [National Horizon Scanning Centre]

Irbesartan (Aprovel) for prevention of cardiovascular complications in patients with persistent atrial fibrillation (2008)[National Horizon Scanning Centre]

Oral anticoagulants for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks (2007) [Cochrane]

Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation (2010) [Cochrane]

Atrial fibrillation (acute onset) (2010) [Clinical Evidence] Athens Log-in required

Atrial fibrillation (chronic)(2011)[Clinical Evidence]Athens Log-in required

Is pulse palpation helpful in detecting atrial fibrillation: a systematic review (2006) [DARE]

Percutaneous radiofrequency ablation for atrial fibrillation (2006) [NICE]

Percutaneous occlusion of the left atrial appendage for atrial fibrillation (2006) [NICE]

High-intensity focused ultrasound for atrial fibrillation in association with other cardiac surgery (2006) [NICE]

Radiofrequency ablation for atrial fibrillation in association with other cardiac surgery (2005) [NICE]

Microwave ablation for atrial fibrillation in association with other cardiac surgery (2005) [NICE]

Cryoablation for atrial fibrillation in association with other cardiac surgery (2005) [NICE]

Pharmacological cardioversion for atrial fibrillation and flutter (2005) [Cochrane]

Electrical cardioversion for atrial fibrillation and flutter (2005) [Cochrane]

Antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks (2005) [Cochrane]

Anticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischaemic attack (2004) [Cochrane]

Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack (2004) [Cochrane]



Clinical Guidelines

Atrial Fibrillation (AF)(2012) [Map of Medicine] updated

Guidelines for the management of atrial fibrillation (2010) [ESC]

Atrial Fibrillation (2009) [CKS]

Atrial Fibrillation: The management of Atrial fibrillation (2006) [NICE]



Recent articles in core journals

Subclinical atrial fibrillation and the risk of stroke (2012)[NEJM]NEW

Atrial fibrillation (2012)[Lancet]NEW

In the clinic. Atrial fibrillation (2010)[Ann Intern Med]

Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators (2009) [Evidence Updates]

Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study (2009) [Lancet]




eTextbooks

Atrial fibrillation: diagnosis and management (2011)[BMJ Learning] updated


Atrial Fibrillation (2010) [eMedicine] updated



Clinical Queries

A patient has a history of coronary artery disease and bypass graft and is taking an antiplatelet in the form of clopidogrel. Has recently been diagnosed with atrial fibrillation and warfarin has been initiated. Is there evidence/guideline to suggest whether he should continue clopidogrel for its antiplatelet effect, or should this be discontinued once warfarin treatment is established? I note a previous Attract answer to a similar query in 2009 - any more recent guidance? (2012) [ATTRACT]NEW

Would the levonorgestrel releasing intrauterine system be a suitable method for a woman who has had surgery for removal of four atrial myxomas, has atrial fibrillation and is taking aspirin and if so does she require antibiotic prophylaxis? (2011) )[FSRH] NEW

What is the incidence of Atrial fibrillation (AF) in children under 15. Can AF be familial? (2009)[ATTRACT]

What is the evidence for an alternative anticoagulation e.g. dipyridamole in a patient with AF, who is allergic to aspirin and that warfarin is contra-indicated? (2008) [TRIP Answers]

What is the clinical evidence that a patient under 65 years of age with persistant AF would benefit from long term antithrombotic therapy? (2008) [TRIP Answers]

Is there any evidence or guidance available on the most appropriate way to initiate Warfarin in patients newly diagnosed with chronic AF in the community? (2008)[ATTRACT]



Patient Information

Atrial Fibrillation (2011) [NHS Choices]
Atrial Fibrillation (2010) [Patient UK]



Important

1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at questions@attract.wales.nhs.uk or call 01495 332343.

2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.