Atrial fibrillation: diagnosis and management

Update information

30 June 2021: We further corrected recommendation 1.2.2 on using the ORBIT score to assess bleeding risk to reinstate the link to the previous calculation tool, which was amended in error on 10 June. The tool includes the full criteria, including options for reduced haemoglobin and reduced haematocrit which are available once the patient's sex has been selected.

10 June 2021: We amended recommendation 1.2.2 on using the ORBIT score to assess bleeding risk so that it links to a calculation tool that includes the full list of criteria, including reduced haemoglobin, reduced haematocrit and history of anaemia. We deleted a paragraph of text from the rationale and impact section for recommendation 1.8.3 that was included incorrectly.

April 2021: We have reviewed the evidence and made new recommendations on diagnosis and assessment, assessment of stroke and bleeding risks, preventing stroke, rate and rhythm control, preventing recurrence, and preventing and managing postoperative atrial fibrillation. These recommendations are marked [2021].

Recommendations marked [2014] and [2006] last had an evidence review in 2014 and 2006 respectively. In some cases, minor changes have been made to the wording for clarity and to bring the language and style up to date, without changing the meaning.

Minor changes since publication

August 2023: As part of our work to make our guidance more useful and usable, we are testing out some changes to improve the way we present our guidance.

Recommendations from the following technology appraisals guidance have been brought into this guideline:

This is so that healthcare professionals can see our recommendations for these medicines quickly, at the right point in this guideline and without having to click onto another page.

This is something we are testing with our users at the moment. It is not the final presentation. Tell us what you think using our survey, or if you have any questions, contact us at contenttransformation@nice.org.uk.

January 2022: Minor changes to redirect NICE Pathways links.

October 2021: We added a link to NICE's shared decision making guideline in recommendation 1.4.2.

ISBN: 978-1-4731-4043-1