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Fibrillazione atriale: pubblicate le nuove linee guida USA

Pubblicato mercoledì 9 Aprile 2014

Sono state pubblicate su Circulation e sul Journal of the American College of Cardiology dai ricercatori dell’American Heart Association in collaborazione con l’American College of Cardiology e la Heart Rhythm Society, le nuove linee guida Usa sulla fibrillazione atriale. Secondo il coordinatore del gruppo di lavoro che ha elaborato il documento, Craig January, le nuove linee guida sulla gestione del paziente con fibrillazione atriale presentano alcune importanti novità:

  • Sostengono un uso più ampio dell’ablazione a radiofrequenze nella FA non valvolare
  • Aggiungono 3 nuovi anticoagulanti orali alle opzioni di trattamento
  • Diminuzione dei casi in cui è consigliato l’uso dell’aspirina
  • Un calcolatore del rischio più ampio e dettagliato, chiamato CHA2DS2 VASc, rispetto al precedente (CHADS2)

John Mandrola (elettrofisiologo) su theHeart.org | Medscape/Cardiology elenca i punti chiave del documento e fa notare che nelle raccomandazioni sulla terapia antitrombotica è scritto “In patients with AF, antithrombotic therapy should be individualized based on shared decision-making after discussion of the absolute and [relative risks] RRs of stroke and bleeding and the patient’s values and preferences”: le preferenze del paziente, dunque, devono essere prese in considerazione.  Un documento in cui, sempre secondo Mandrola “gli autori hanno per lo più evitato di dire cosa fare. Hanno invece esposto in modo conciso e chiaro le evidenze. Hanno poi enfatizzato le preferenze del paziente e la condivisione delle decisioni”.

Fonti: January CT, Wann L, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2014;CIR.0000000000000041published online before print March 28 2014, doi:10.1161/CIR.0000000000000041
January CT, Wann L, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;():. doi:10.1016/j.jacc.2014.03.022.
Mandrola J: 2014 AF Treatment Guidelines: 10 Things to Like and Only One to Dislike. 31 marzo 2014.

Comunicati stampa
American College of Cardiology. Cardiosource: New ACC/AHA/HRS Guideline Addresses Management of Patients With Afib. 28 marzo 2014.
American College of Cardiology. Cardiosource: New Afib Guideline Covers Novel Anticoagulants, Ablation. More Comprehensive Risk Calculator Recommended. 29 marzo 2014.

Versione per pazienti American College of Cardiology. CardioSmart. Atrial Fibrillation Guidelines 2014.

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