Guides AF management strategy including anticoagulation, rate vs rhythm control decisions
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Clinical background · Scoring criteria · Evidence-based pearls
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting over 59 million people globally. Its prevalence doubles with each decade of age after 55. AF-related stroke accounts for approximately 30% of all ischaemic strokes — the majority preventable with anticoagulation guided by CHA₂DS₂-VASc risk stratification. The management of AF has been transformed by three major evidence bases: (1) DOACs (direct oral anticoagulants) replacing warfarin for stroke prevention, (2) catheter ablation becoming first-line rhythm control for symptomatic paroxysmal AF (EARLY-AF, STOP-AF trials), and (3) EAST-AFNET 4 demonstrating mortality benefit of early rhythm control vs rate control in patients with AF <1 year.
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