New guildelines for treating AFib

Role of aspirin diminished in new recommendations


When someone is diagnosed with atrial fibrillation, or AFib, their heart may beat too fast, too slow, or with an irregular rhythm. It is the most common heart rhythm disorder. Today, new guidelines have been released on how to treat it.

"The thing that you're trying to prevent the most is stroke. So, I think this document now goes into more granular calculation for the risk of stroke," said Dr. Oussama Wazni, who did not help with the guidelines but is a cardiologist at Cleveland Clinic.

For people who have AFib but no significant disease in any of the four valves of the heart, the guidelines recommend an increased use of radio frequency ablation.  It's a technique that uses heat to destroy tiny areas in the heart that are causing the irregular heartbeat.

The recommendations also include three new anticoagulants as treatment options, but diminish the role of aspirin. Previous treatment protocols called for doctors to prescribe aspirin to patients with AFib who had low stroke risk, but researchers say the data behind the move is weak.


"Aspirin does not prevent stroke. It's not very effective at preventing stroke and on the other hand it can cause bleeding," explained Wazni.

The guidelines include a more comprehensive stroke-risk calculator. It puts more emphasis on things like age and gender. Researchers say the goal was to make the new guidelines clear and easy to use.

Wazni says they should help physicians develop more personalized treatment plans for people with AFib.

"There used to be some gray zones, but now some of these gray zones have been clarified and it makes it easier for the physician to deal with atrial fibrillation, especially in a patient who has a high risk of stroke" said Wazni.

The guidelines are being published in the Journal of the American College of Cardiology.