J Korean Med Assoc.  2019 May;62(5):265-274. 10.5124/jkma.2019.62.5.265.

Guideline of atrial fibrillation management

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. cby6908@yuhs.ac

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. The Korean Heart Rhythm Society organized a Korean Atrial Fibrillation Management Guideline Committee and analyzed all available studies regarding the management of AF, including studies on Korean patients. This guideline is based on recent data of the Korean population and the recent guidelines of the European Society of Cardiology, European Association for Cardio-Thoracic Surgery, American Heart Association, and Asia Pacific Heart Rhythm Society. Expert consensus or guidelines for the optimal management of Korean patients with AF were achieved after a systematic review with intensive discussion. This article provides general principles for appropriate risk stratification and selection of anticoagulation therapy in Korean patients with AF. This guideline deals with optimal stroke prevention, screening, rate and rhythm control, risk factor management, and integrated management of AF.

Keyword

Atrial fibrillation; Guideline; Anticoagulants; Therapy

MeSH Terms

American Heart Association
Anticoagulants
Arrhythmias, Cardiac
Asia
Atrial Fibrillation*
Cardiology
Consensus
Heart
Humans
Mass Screening
Risk Factors
Stroke
Anticoagulants

Figure

  • Figure 1 Annual prevalence (A) and incidence (B) of atrial fibrillation (AF), 2006–2015, stratified by sex. Reproduced from Joung B et al. Korean Cir J 2018;48:1033-1080, according to the Creative Commons license [1]. a)P<0.05. b)P<0.001.

  • Figure 2 Annual incidence (A) and prevalence (B) of atrial fibrillation (AF), 2006–2015, stratified by age. Reproduced from Joung B et al. Korean Cir J 2018;48:1033-1080, according to the Creative Commons license [1]. a)P<0.05. b)P<0.001.

  • Figure 3 The projected prevalence of atrial fibrillation. Reproduced from Joung B et al. Korean Cir J 2018;48:1033-1080, according to the Creative Commons license [1].

  • Figure 4 Temporal trends of newly diagnosed atrial fibrillation patient by CHA2DS2-VASc (A) and HAS-BLED scores (B), 2006–2015. Reproduced from Joung B et al. Korean Cir J 2018;48:1033-1080, according to the Creative Commons license [1].

  • Figure 5 Temporal trends in 1-year adverse event rates of prevalent atrial fibrillation Korean population each year. HF, heart failure. a)P-value for trends <0.001. Reproduced from Joung B et al. Korean Cir J 2018;48:1033-1080, according to the Creative Commons license [1].

  • Figure 6 The basic concept of acute and chronic management of atrial fibrillation. OAC, oral anticoagulation therapy; VKA, vitamin K antagonist; TTR, time in therapeutic range; NOAC, non-vitamin K antagonist oral anticoagulant. Reproduced from Joung B et al. Korean Cir J 2018;48:1033-1080, according to the Creative Commons license [1].

  • Figure 7 Stroke prevention strategy in patients with atrial fibrillation. NOAC, non-vitamin K oral anticoagulant; OAC, oral anticoagulation. a)A congestive heart failure, hypertension, age ≥75 (doubled), diabetes mellitus, prior stroke or transient ischemic attack (doubled), vascular disease, age 65–74, female. Reproduced from Joung B et al. Korean Cir J 2018;48:1033-1080, according to the Creative Commons license [1].

  • Figure 8 Management of bleeding in patients taking oral anticoagulants. INR, international normalized ratio; IV, intravenous; NOAC, non-vitamin K oral anticoagulant. Adapted from Joung B et al. Korean Cir J 2018;48:1033-1080 [1].


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