Results:

Most recommendations are either identical or overlap between all three sets of guidelines. There are differences, with respect to how structural heart disease is defined, when determining the appropriateness of antiarrhythmic drug therapy. The CCS guidelines only consider heart failure or an ejection fraction <35% as structural heart disease. The recommendations differ slightly in their intensity and the level of intensity to recommend catheter ablation as an alternative to antiarrhythmic drug therapy. The ESC guidelines indicate ablation as first-line therapy in appropriately selected patients with paroxysmal atrial fibrillation with no or minimal heart disease (including left ventricular hypertrophy with preserved left ventricular function). There are differences regarding the dosing of dabigatran, closely linked to national regulatory influences. There are differences in the acceptability of dronedarone in patients with heart failure (with European guidelines reflecting the European Medicines Agency revised label of this medication, which excludes its use in heart failure) and the need for monitoring of liver function.