Atrial fibrillation (AF)

Diagnostic and therapeutic approach


When AF is diagnosed we have to decide about:

  1. Eventual anticoagulation based on CHADs-VASC score. Bleeding risk must be calculated with the HAS-BLED score.
  2. Rhythm control = cardioversion.
  3. Heart rate control.

Alternative to anticoagulation exists, like percutaneous closure of the left atrial appendage (LAA).

Heart rate control

  • Ideally the average frequency over 24 hours must be between 60 and 80 bpm at rest and between 90 and 120 bpm during exercise.
  • If impossible frequency control with medication, consider the AV node ablation and pacemaker implantation.

1. Absence of heart failure

2. Heart failure