This evidence-based guideline provides complete best practice guidance on the diagnosis and management of atrial fibrillation (AF) in most clinical situations related to this common cardiac arrhythmia.

The Guideline:
* covers paroxysmal, persistent and permanent AF
* considers AF developing after surgical procedures
* offers advice on haemodynamically unstable AF
* gives recommendations for referral to specialist services
* provides full details of systematic reviews of the AF evidence base and health group modelling and considerations of the Guideline Development Group who were drawn from the country's leading experts in the field.

Many of the recommendations relate to control of AF and the important decision of whether to attempt to restore sinus rhythm or to concentrate on control of the heart rate. In a linked set of recommendations, the importance of considering anticoagulation in all these patients is emphasised. This is sometimes neglected in clinical practice even though anticoagulation is of enormous potential benefit because of its role in stroke prevention. One of the key recommendations in the guideline is that the risk of thromboembolism should be formally assessed, and a simple clinical model which includes advice on appropriate prophylaxis is suggested for this purpose. Other key recommendations cover the use of ECG in diagnosis, and the preference in most patients for beta-blockers or rate-limiting calcium antagonists over digoxin for rate-control.

The guideline provides selected recommendations as key priorities for implementation, algorithms for everyday practice use and suggests topics for clinical audit as well as future research priorities.

THE DEVELOPMENT

Introduction
Methodology
Key messages of the guideline

THE GUIDELINE

Identification and diagnosis
Cardioversion
Treatment of persistent AF
Treatment for permanent AF
Treatment for paroxysmal AF
Treatment for acute onset AF
Postoperative AF
Antithrombotic therapy
Monitoring and referral
Appendices
References