Atrial Fibrillation: Diagnosis and Management (NICE NG196)

NICE NG196 covers the diagnosis and management of atrial fibrillation including stroke risk assessment, anticoagulation, and rate/rhythm control strategies.

Key Recommendations

• Use CHA2DS2-VASc score to assess stroke risk in AF
• Offer anticoagulation to men with CHA2DS2-VASc ≥2 and women with ≥3 (consider at ≥1/≥2)
• Offer DOAC in preference to warfarin unless contraindicated (mechanical heart valve, moderate-severe mitral stenosis)
• Rate control: rate-limiting CCB (diltiazem/verapamil) or beta-blocker as first-line
• Consider rhythm control for all new presentations, younger patients, or symptomatic AF
• Catheter ablation for symptomatic AF if antiarrhythmic drugs ineffective or not tolerated