Key Patient Messages: 2023 Atrial Fibrillation Clinical Practice Guideline

Published: November 30, 2023

  1. Atrial fibrillation (AFib) is the most common type of irregular heart rhythm, and it is becoming more common, reflecting an aging population, better ways of detecting AFib, and better survival rates in people with previous AFib or other heart diseases. Over 5 million people in the United States live with AFib.
  2. The most common symptoms for AFib are a racing heartbeat or abnormal palpitations, shortness of breath, or feeling lightheaded or dizzy.
  3. There are many ways to detect an irregular heartbeat, including a wearable device (such as a smartwatch). Healthcare professionals are taking the results of these devices more seriously because the technology is becoming more sophisticated and reliable.
  4. The 2023 Atrial Fibrillation Clinical Practice Guideline gives health care professionals the latest information on how patients with AFib can be diagnosed and treated. The guideline also highlights three important topics for health care providers and patients to discuss:


    • Stroke risk assessment and treatment as appropriate
    • Optimization of all modifiable risk factors (making lifestyle changes to reduce the risk of AFib or improve symptoms for those with AFib)
    • Symptom management, using drugs and procedures that manage the heart’s rate and rhythm. Controlling heart rhythm early is important to treating AFib.
  5. The biggest health concern relating to AFib is stroke. During AFib, the heart pumps blood abnormally. Because the blood isn’t circulating properly, this may cause blood to pool in the heart and form clots. These clots can travel through blood vessels into the brain, causing a blockage leading to stroke.
  6. Patients with AFib may be given blood thinners to guard against stroke. There are now safer and easier ways to administer blood thinners for most patients with AFib, through DOACs which stands for Direct Oral Anticoagulants.
  7. Treatment for AFib may change over time as symptoms change. Patients should discuss any changes in symptoms with their health care provider.
  8. In most cases, health care providers treat AFib using drugs that manage the heart’s rhythm and/or to keep the heart rate from beating too fast (called rate control). If medicines do not improve abnormal rhythm and/or rate, there are surgical procedures to help manage AFib including electrical cardioversion and catheter ablation.
  9. Shared-decision making is important to heart health care. This is when a patient and health care provider make decisions together that consider the patient’s goals and preferences for managing their AFib, and the health care provider ensures the patient understands their treatment options. Patients should never be afraid to ask their doctor questions or ask for an explanation of any aspect of their diagnosis. This includes information on the cost of procedures and drugs used to manage AFib. Patients can also find more information on AFib and look to reputable and reliable sources like the American Heart Association.
  10. For patients with AFib, partnering with their health care provider, taking medications appropriately, and taking charge of their lifestyle choices will lead to better AFib outcomes.

Read the American Heart Assocition Journals' Centennial Collection --- A Tribute to the AHA's 100th Anniversary