Atrial Fibrillation Protocols

Abstract

Atrial fibrillation incidence is growing exponentially, far beyond earlier estimations. In the past, physicians and nurses were under the impression that this was a fairly benign occurrence, much to the detriment of patient well-being and survival. We are generally slow to adopt evidence and guideline-directed medical therapy, but in light of the phenomenon, we must employ evidence-based practices sooner and save these patients from lifestyle deterioration, heart failure, the eventual stroke, and potential death.

Standardized order sets and flowcharts created following guideline-directed medical therapy will ensure patients receive the recommended care. Anticoagulation, rate and rhythm control, and cardioversion protocols should be addressed. Absolute confirmation of the onset of atrial fibrillation guides cardioversion decision, with or without TEE and anticoagulation. If unknown, assume it is longer than 48 h.

The society has received permission to share these examples from certified and accredited atrial fibrillation centers. It is the responsibility of all to share knowledge and proven practices with others to provide efficient, cost-effective, and, above all, safe care.