The document summarizes guidelines for managing atrial fibrillation. It discusses recommendations for stroke prevention using anticoagulants, rate control therapy, and rhythm control therapy. It also recommends catheter ablation of accessory pathways in Wolff-Parkinson-White syndrome patients with atrial fibrillation to prevent rapid conduction across pathways leading to dangerous arrhythmias.

1. 2016 ESC Guidelines for
the management of atrial
fibrillation

5. Valvular AF ?

6. Term valvular AF

10. 1. Stroke prevention in atrial
fibrillation

12. Characteristics of approved Non-vitamin K
antagonist oral anticoagulants compared

16. Secondary stroke
prevention

18. • Recommendations
for secondary
stroke prevention

20. Recommendations for
management of bleeding

23. Combination therapy with oral
anticoagulants and antiplatelets

28. 2.Rate control therapy in atrial
fibrillation

33. 3. Rhythm control therapy in
atrial fibrillation

34. Rhythm control management of recent onset atrial fibrillation

37. Initiation of long term rhythm control therapy in symptomatic
patients with atrial fibrillation

40. Wolff–Parkinson–White syndrome
Patients with pre-excitation and AF are at risk of rapid conduction across the accessory
pathway, resulting in a fast ventricular rate, possible ventricular fibrillation, and
sudden death. In AF patients with evidence of an antegrade accessory pathway,
catheter ablation of the pathway is recommended. This procedure is safe and effective
and may be considered as a prophylactic treatment strategy. In AF patients surviving a
sudden death event with evidence of an accessory pathway, urgent catheter ablation
of the pathway is recommended. A documented short pre-excited RR interval ( < 250
ms) during spontaneous or induced AF is one of the risk markers for sudden death in
Wolff–Parkinson–White syndrome (WPW) syndrome, in addition to a history of
symptomatic tachycardia, the presence of multiple accessory pathways, and Ebstein’s
anomaly. Intravenous procainamide, propafenone, or ajmaline can be used to acutely
slow ventricular rate, whereas digoxin, verapamil, and diltiazem are contraindicated.
Intravenous amiodarone should be used with caution, as there are case reports of
accelerated ventricular rhythms and ventricular fibrillation in patients with preexcited
AF receiving intravenous amiodarone infusion.