Commentary on the ESC guidelines on atrial fibrillation

The new guidelines for the management of atrial fibrillation issued by the European Society of Cardiology summarize the evidence for the management of atrila fibrillation patients in 210 recommendations. AF requires therapy of associated cardiovascular disorsders, anticoagulant therapy, rate control, and to relieve symptoms rhythm control therapy. To prevent strokes in AF, oral anticoagulation outperforms antiplatelet therapy in almost all patients. Rate control may be lenient in most patients. To assess symptoms, the EHRA score is useful. Rhythm control therapy should be guided by safety considerations,whether it relies on antiarrhythmic drugs or on catheter ablation. These guidelines represent a reasonable guidance for AF management, applicable in the majority of patients. New data will call for renewal of the guidelines in due time, possibly already in 2012.