Samenvatting van de standaard 'Atriumfibrilleren' (eerste herziening) van het Nederlands Huisartsen Genootschap

The revised practice guideline 'Atrial fibrillation' from the Dutch College of General Practitioners provides the general practitioner with guidelines for diagnosis and management of patients with atrial fibrillation. To find patients with atrial fibrillation, it is advised to check cardiac rhythm at every blood pressure measurement. In patients over 65 years old, acceptance of atrial fibrillation with control of ventricular rate is preferred to sinus rhythm normalisation. In therapy with beta-blockers, slow release metoprolol is the drug of choice. An important goal of treatment is the prevention of thrombo-embolic complications. The choice between anticoagulants such as aspirin and coumarin derivatives is based on the CHADS2 score and determined by age (above 75 years) and comorbidity including cardiac failure, diabetes, hypertension, and previous transient ischaemic attack (TIA) or cardiovascular accident (CVA). The adequacy of antithrombotic treatment should be reassessed yearly.