José A. Joglar, Mina K. Chung, Anastasia L. Armbruster, Emelia J. Benjamin, Janice Y. Chyou et al.Circulation · 2023 · 2182 citationsDOI: 10.1161/cir.0000000000001193
career-transition
Abstract
AIM: The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS: A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE: Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.
ETF perspective
Why this matters
Atrial fibrillation is prevalent in the athlete-transition population, particularly among older former competitive athletes. This guideline provides the evidence base practitioners need when clients present with cardiac arrhythmia symptoms during physical reconditioning.
ETF summary
The 2023 ACC/AHA guideline updates recommendations for diagnosing and managing atrial fibrillation, including updated anticoagulation strategies, ablation criteria, and risk modification approaches. It replaces the 2014 guideline and its 2019 update.
Practitioner takeaway
When a client in physical transition reports heart palpitations, irregular rhythm, or exercise intolerance, refer promptly for cardiac evaluation. Lifestyle and risk-factor modification (stress, deconditioning, alcohol) overlap directly with the transition period.
Academic citation. ETF Framework does not provide clinical services. Research summaries reflect ETF practitioner interpretation and do not constitute medical or psychological advice.