Provides the 2018 Korean Heart Rhythm Society guidelines for the integrated management of nonvalvular atrial fibrillation in primary care and specialized settings.
Mandates prompt AF management at first detection; extends guidelines to asymptomatic elderly for stroke and HF prevention.
Atrial fibrillation (AF) is the most common form of sustained arrhythmia in elderly patients. However, AF is often detected during health screening, or accidentally during testing for other diseases; some patients lack clinical symptoms. Nevertheless, AF increases the incidence of ischemic stroke and other thrombotic events, and compromises cardiovascular prognosis in terms of heart failure, dementia, and hospitalization. Therefore, initial AF management should be performed at the point of primary care, not only in specialized medical centers. We wish to propose a five-step management protocol for AF. We review the evidence supporting integrated management by primary care physicians new to AF, and by specialized physicians who often diagnose and manage AF. Further, we also outline a structured goal-based follow-up protocol; this is an important part of integrated management.
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Park et al. (2018) studied this question.
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