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Atrial Fibrillation (Management of) 2010 and Focused Update (2012)

ESC Clinical Practice Guidelines

Topics: Atrial Fibrillation


Webinars and WebcastsProfessor Bax talks about the ESC Guidelines

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1–2% of the general population.

25/08/2012 00:00:00

Current versions available to download

Publication dateVersionsReferencesSize
2011Corrigendumdoi:10.1093/eurheartj/ehq512106 KB
2012CorrigendumCorrigendum-AFib-Focused-Update-2012-EHJ-doi:10.1093/eurheartj/eht02762 KB
2010Full TextEuropean Heart Journal (2010) 31, 2369–2429
2012Full TextEuropean Heart Journal (2012) 33, 2719–2747
2012Pocket GuidelinesTable of Contents
 PdaDownload the PDA version
2011 Slide-set2010 Guidelines slides on AFIB9 MB
2012 Slide-setSlides AFIB focused update 20123 MB
 CME QuestionsCME Questions AFIB
2010Related MaterialsAFIB - Additional References 2 MB
2011Related MaterialsESC Statement on Dronedarore45 KB

Current translated versions available to download:


Focused update 2012
A. John Camm (Chairperson),Gregory Y.H. Lip, Dan Atar, Raffaele de Caterina, Gerhard Hindricks, Stefan Hohnloser, Paulus Kirchhof, Irina Savelieva

Version 2010
A. John Camm FESC (Chairperson), Paulus Kirchhof FESC, Gregory Y. H. Lip FESC, Ulrich Schotten, Irene Savelieva, Sabine Ernst FESC, Isabelle C. Van Gelder FESC, Nawwar Al-Attar, Gerhard Hindricks FESC, Bernard Prendergast FESC, Hein Heidbuchel FESC, Ottavio Alfieri FESC, Annalisa Angelini FESC, Dan Atar FESC, Paolo Colonna FESC, Raffaele De Caterina FESC, Johan De Sutter FESC, Andreas Goette, Bulent Gorenek FESC, Magnus Heldal FESC, Stefan Hohnloser FESC, Philippe Kolh FESC, Jean-Yves Le Heuzey FESC, Piotr Ponikowski FESC, Frans H. Rutten

Declarations of Interest of the experts involved in the elaboration of the 2010 document.

Declarations of Interest of the experts involved in the elaboration of the 2012 document.

Endorsed by:

Table of contents: Focused Update (2012)

Stroke and bleeting risk assessment
New oral anticoagulants
Left atrial appndage closure
Cardioversion with pharmacological agents
Catheter ablation of atrial fibrillation
Concluding remarks

Table of contents: Full Text 2010 (ESC Clinical Practice Guidelines)

Abbreviations and acronyms



  • Epidemiology
  • Mechanisms of atrial fibrillation

Detection, 'natural' history and acute management

  • Definition
  • Detection
  • "Natural" time course
  • Electrocardiogram techniques to diagnose and monitor atrial fibrillation
  • Types of atrial fibrillation
  • Initial management
  • Clinical follow-up


Antithrombotic management

  • Risk stratification for stroke and thrombo-embolism
  • Antithrombotic therapy
  • Anticoagulation therapy with vitamin K antagonist vs control
  • Antiplatelet therapy vs control
  • Anticoagulation therapy with vitamin k antagonist vs antiplatelet therapy
  • Other antithrombotic drug regimens
  • Investigational agents
  • Current recommendations for antithrombotic therapy
  • Risk of bleeding
  • Optimal international normalized ratio
  • Special situations
  • paroxymal atrial fibrilllation
  • Perioperative anticoagulation
  • Stable vascular disease
  • ACS and/ or PCI
  • Elective PCI
  • Non-St elevation myocardial infraction
  • Acute ST segment elevation myocardial infarction with primary percutaneous intervention
  • Acute stroke
  • Atrial flutter
  • Cardioversion
  • Tansoesophageal echocardiogram-guided cardioversion
  • Non-pharmacological methods to prevent stroke

Rate and rhythm management

  • Acute rate and rhythm management
  • Acute rate control
  • Pharmacological conversion
  • "Pill-in-the-pocket" approach
  • Direct current cardioversion

Long term management

  • Rate and rhythm control
  • long term rate control
  • Parmacological rate control
  • Atrioventricular node abaltation and modification
  • Long term rhythm control
  • Antiarrhythmic drugs to maintain sinus rhythm
  • Left atrial catheter ablation
  • Surgical ablation

Upstream therapy

  • Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers
  • Aldosterone antagosnists
  • Statins
  • Polyunsaturated fatty acids

Specific population

  • Heart failure
  • Athletes
  • Valvular heart disease
  • Acute coronoray syndromes
  • Diabetes mellitus
  • The elderly
  • Pregnancy
  • Post-operative atrial fibrillation
  • Hyperthyroidism
  • Wolf-Parkinson-White syndrome
  • Hypertrophic cardiomyopathy
  • Pulmonary disease

Previous versions

2006: Corrigendum to ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation:
Full Text
Executive Summary

2001:Euro Heart Journal 2001; 22, 1852–1923: Atrial Fibrillation (Management of):
Full text | Executive Summary