FUSTER
ET AL., ACC/AHA/ESC GUIDELINES FOR THE MANAGEMENT OF
PATIENTS WITH ATRIAL FIBRILLATION
J Am Coll Cardiol 2001;38:1266i-1xx
ACC/AHA/ESC
Guidelines for the Management of Patients with Atrial
Fibrillation
Preamble
It
is important that the medical profession play a significant
role in critically evaluating the use of diagnostic
procedures and therapies in the management or prevention
of disease states. Rigorous and expert analysis of the
available data documenting relative benefits and risks
of those procedures and therapies can produce helpful
guidelines that improve the effectiveness of care, optimize
patient outcomes, and affect the overall cost of care
favorably by focusing resources on the most effective
strategies.
The
American College of Cardiology (ACC) and the American
Heart Association (AHA) have jointly engaged in the
production of such guidelines in the area of cardiovascular
disease since 1980. The ACC/AHA Task Force on Practice
Guidelines, whose charge is to develop and revise practice
guidelines for important cardiovascular diseases and
procedures, directs this effort. The Task Force is pleased
to have this guideline co-sponsored by the European
Society of Cardiology (ESC). This is the first such
joint effort. The Task Force wishes to acknowledge the
important contributions of Jean-Pierre L. Bassand, MD,
FESC, the previous chair of the ESC Scientific and Clinical
Initiatives Committee, who helped initiate this joint
effort. Experts in the subject under consideration have
been selected from all 3 organizations to examine subject-specific
data and write guidelines. The process includes additional
representatives from other medical practitioner and
specialty groups where appropriate. Writing groups are
specifically charged to perform a formal literature
review, weigh the strength of evidence for or against
a particular treatment or procedure, and include estimates
of expected health outcomes where data exist. Patient-specific
modifiers, comorbidities, and issues of patient preference
that might influence the choice of particular tests
or therapies are considered, as well as frequency of
follow-up and cost-effectiveness.
The
ACC/AHA Task Force on Practice Guidelines and the ESC
make every effort to avoid any actual or potential conflicts
of interest that might arise as a result of an outside
relationship or personal interest of a member of the
writing panel. Specifically, all members of the writing
panel are asked to provide disclosure statements of
all such relationships that might be perceived as real
or potential conflicts of interest. These statements
are reported orally to all members of the writing panel
at the first meeting and updated as changes occur.
These
practice guidelines are intended to assist physicians
in clinical decision making by describing a range of
generally acceptable approaches for the diagnosis, management,
or prevention of specific diseases or conditions. These
guidelines attempt to define practices that meet the
needs of most patients in most circumstances. The physician
and patient must make the ultimate judgment regarding
care of a particular patient in light of general information
and specific circumstances.
The
executive summary and recommendations are published
in the October issue of the Journal of the American
College of Cardiology and the October 23 issue of
Circulation. The full text of these guidelines
is published in the mid-October issue of the
European Heart Journal. Reprints of the full text
guidelines are available from the ESC; single reprints
of the executive summary are available from the ACC;
bulk reprints of the full text and executive summary
are available from the AHA. These guidelines are available
on the ACC, AHA, ESC, and NASPE World Wide Web sites.
The guidelines have been officially endorsed by the
North American Society of Pacing and Electrophysiology.
Raymond
J. Gibbons, MD, FACC
Chair, ACC/AHA Task Force on Practice Guidelines
|
Werner
W. Klein, MD, FACC, FESC
Chair, ESC Committee for Practice Guidelines and
Policy Conferences |
Copyright © 2001 by the American College of Cardiology,
American Heart Association, Inc., and the European Society
of Cardiology
Published by Elsevier Science Inc.
|
