Giuseppe Boriani, Davide Antonio Mei, Marco Vitolo, Jacopo Francesco Imberti
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The 2024 ESC guidelines on atrial fibrillation: essential updates for everyday clinical practice.
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, and it is associated with substantial morbidity, mortality, and economic burden. Effective management of AF remains a critical focus in contemporary medicine, given its complex and multifaceted nature. In the present paper, we provide the essential updates for everyday clinical practice from the 2024 European Society of Cardiology (ESC) guidelines for AF management. We highlight seven key areas encompassing the adoption of the CHA₂DS₂-VA score for thromboembolic risk stratification, changes in bleeding risk assessment, expanded indications for catheter ablation, promotion of the multidisciplinary AF-CARE pathway for patient management, new recommendations for left atrial appendage closure, updates on clinical decision-making for atrial high-rate episodes, and considerations on the future role of artificial intelligence in advancing predictive analytics. We also compare the new recommendations proposed by the ESC 2024 AF guidelines with the ESC 2021 edition and the 2023 guidelines published by the American College of Cardiology/American Heart Association (ACC/AHA), reflecting regional perspectives and advancements in the field. By presenting these practical updates and their implications for routine practice, this paper aims to guide clinicians in adopting the latest evidence-based approaches to optimize AF patients' care.
期刊介绍：
Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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