Atrial fibrillation – NICE guidance April 2021

If you suspect AF perform a manual palpation of pulse- this includes people presenting with breathlessness palpitations syncope or dizziness chest dicomfort stroke or TIA

If irregular pulse is felt arrange a 12 lead ECG in all ( with or without symptoms ) If paroxysmal AF is suspected and it is not detected by a 12 lead ECG consider use of ( PF are episodes of AF that stop within 7 days , usually within 48 hrs without any treatment )○ 24 hr ambulatory ECG if asymptomatic episodes are suspected or symptomatic episodes are < 24 hrs apart ○ for longer duration NICE suggests ambulatory ECG monitor , event recorder or other ECG technology ( this would be undertaken usually by specialist cardiology team )Wearable and other devices -the committee has acknowledged that there is some evidence that some new devices were accurate and and showed promise

CHA2DS2VASC Score AF which is symptomatic or asymptomatic , persistent or permanent atrial flutter people at risk of arrhythmia recurrence after cardioversion back to SR or catheter ablationA score of 2 or more is considered as the ideal threshold for anticoagulation. The committee also felt that men with a CHA2D.. score of 1...