Atrial fibrillation

Also known as: AF · AFib · atrial flutter

United StatesACC/AHA

Current

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation

ACC/AHA/ACCP/HRS · 2023

Supersedes the 2019 AHA/ACC/HRS version

The current US atrial-fibrillation guideline. It reframes AF into stages and emphasizes early, comprehensive risk-factor and rhythm management.

Introduces a four-stage classification of AF spanning risk factors through permanent AF. source
Emphasizes early rhythm control and lifestyle / risk-factor modification. source
Positions catheter ablation as reasonable first-line therapy in selected patients. source

Verify against original ↗

EuropeESC

Current

2024 ESC Guidelines for the management of atrial fibrillation

ESC (with EACTS) · 2024

Supersedes the 2020 ESC (with EACTS) version

The current European AF guideline, organized around the patient-centred 'AF-CARE' pathway and developed with the cardiothoracic surgery society (EACTS).

Structures care around the AF-CARE pathway: Comorbidities, Avoid stroke/thromboembolism, Reduce symptoms, Evaluation and dynamic reassessment. source
Emphasizes comorbidity and risk-factor management as a foundation of AF care. source

Verify against original ↗

US vs EU key differences

Both guidelines converge on early rhythm control and broad risk-factor management, but organize it differently — US 'stages of AF' versus the ESC 'AF-CARE' pathway. source
Both endorse catheter ablation as first-line rhythm control in selected patients. source

What changed recently

EU2020 → 20242024-06-15
Reorganizes AF management around the patient-centred AF-CARE pathway, foregrounding comorbidity and risk-factor management.
source ↗
US2019 Focused Update → 20232023-06-15
Replaces the 2014 guideline and 2019 focused update: introduces a four-stage AF classification, emphasizes early rhythm control, and positions catheter ablation as first-line in selected patients.
source ↗

See the full update feed for changes across every system.