The 2014 Atrial Fibrillation Guidelines Companion: A Practical Approach to the Use of the Canadian Cardiovascular Society Guidelines

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• 作者：Laurent Macle ; MD^a ; John A. Cairns ; MD^b ; Jason G. Andrade ; MD^b ; L. Brent Mitchell ; MD^c ; Stanley Nattel ; MD^a ; Atul Verma ; MD^d ; ^{atul.verma@utoronto.ca" class="auth_mail" title="E-mail the corresponding author} ; on behalf of the CCS Atrial Fibrillation Guidelines Committee^e ; Atul Verma ; MD (Co-chair ; Primary Panel) ; Laurent Macle ; MD (Co-chair ; Primary Panel) ; Jason Andrade ; MD (Primary Panel) ; Clare Atzema ; MD (Primary Panel) ; Alan Bell ; MD (Primary Panel) ; John A. Cairns ; MD (Primary Panel) ; Stuart Connolly ; MD (Primary Panel) ; Jafna L. Cox ; MD (Primary Panel) ; Paul Dorian ; MD (Primary Panel) ; David Gladstone ; MD (Primary Panel) ; Jeff Healey ; MD (Primary Panel) ; Kori Leblanc ; PharmD (Primary Panel) ; L. Brent Mitchell ; MD (Primary Panel) ; Stanley Nattel ; MD (Primary Panel) ; Ratika Parkash ; MD (Primary Panel) ; Louise Pilote ; MD (Primary Panel) ; Mike Sharma ; MD (Primary Panel) ; Allan Skanes ; MD (Primary Panel) ; Mario Talajic ; MD (Primary Panel) ; Teresa Tsang ; MD (Primary Panel) ; Subodh Verma ; MD (Primary Panel) ; David Bewick ; MD (Secondary Panel) ; Vidal Essebag ; MD (Secondary Panel) ; Peter Guerra ; MD (Secondary Panel) ; Brett Heilbron ; MD (Secondary Panel) ; Charles Kerr ; MD (Secondary Panel) ; Bob Kiaii ; MD (Secondary Panel) ; George Klein ; MD (Secondary Panel) ; Simon Kouz ; MD (Secondary Panel) ; Michael Sean McMurtry ; MD (Secondary Panel) ; Daniel Ngui ; MD (Secondary Panel) ; Pierre Page ; MD (Secondary Panel) ; Paul Timothy Pollak ; MD (Secondary Panel) ; Jan Surkes ; MD (Secondary Panel) ; D. George Wyse ; MD (Secondary Panel)
• 刊名：Canadian Journal of Cardiology
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：31
• 期：10
• 页码：1207-1218
• 全文大小：642 K

文摘

The Canadian Cardiovascular Society (CCS) Atrial Fibrillation Guidelines Program has generated a comprehensive series of documents regarding the management of atrial fibrillation (AF) between 2010 and 2014. The guidelines provide evidence-based consensus management recommendations in a broad range of areas. These guidelines have proven useful in informing clinical practice, but often lack detail in specifications related to practical application, particularly for areas in which the evidence base is limited or conflicting. Based on feedback from the community, the CCS Atrial Fibrillation Guidelines Committee has identified a number of areas that require clarification to address commonly asked practical questions related to guidelines application. In the present article a number of such questions are presented and suggestions about how they can be answered are suggested. Among the issues considered are: (1) What duration of AF is clinically significant? (2) How are the risk factors in the CCS Algorithm for selecting anticoagulation therapy derived and defined? (3) How is valvular heart disease defined and how do different forms of valve disease affect the choice of anticoagulant therapy for AF patients? (4) How should we quantify renal dysfunction and how does it affect therapeutic choices? The response to these questions and the underlying logic are provided, along with an indication of future research needed where no specific approach can presently be recommended based on the literature.