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NICE Guidance
Conditions and diseases
Cardiovascular conditions
Heart rhythm conditions
Atrial fibrillation: management
Clinical guideline [CG180]
Published date:
June 2014
Last updated:
August 2014
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Do not routinely perform TTE (transthoracic echocardiography) solely for the purpose of further stroke risk stratification in people with atrial fibrillation for whom the need to initiate anticoagulation therapy has already been agreed on appropriate clinical criteria (see section 1.4 Assessment of stroke and bleeding risks and section 1.5 Interventions to prevent stroke).
Do not do
June 2014
Unclassified
Do not withhold anticoagulation solely because the person is at risk of having a fall.
Do not do
June 2014
Unclassified
Do not offer stroke prevention therapy to people aged under 65 years with atrial fibrillation and no risk factors other than their sex (that is, very low risk of stroke equating to a CHA2DS2-VASc score of 0 for men or 1 for women).
Do not do
June 2014
Unclassified
Do not offer aspirin monotherapy solely for stroke prevention to people with atrial fibrillation.
Do not do
June 2014
Unclassified
Do not offer LAAO (left atrial appendage occlusion) as an alternative to anticoagulation unless anticoagulation is contraindicated or not tolerated.
Do not do
June 2014
Unclassified
Do not offer amiodarone for long-term rate control.
Do not do
June 2014
Unclassified
Do not offer class 1c antiarrhythmic drugs such as flecainide or propafenone to people with known ischaemic or structural heart disease.
Do not do
June 2014
Unclassified
Do not offer magnesium or a calcium-channel blocker for pharmacological cardioversion.
Do not do
June 2014
Unclassified
In people undergoing cardiothoracic surgery do not offer digoxin.
Do not do
June 2014
Unclassified
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