Comparing Guidelines for Atrial Fibrillation: Focus on Emergency Medicine.

The European Society of Cardiology and the American College of Cardiology/American Heart Association/American College of Clinical Pharmacy/Heart Rhythm Society both recently updated their guidelines on the management of atrial fibrillation, whereas the Canadian Cardiovascular Society/Canadian Heart Rhythm Society published their most recent guidelines in 2020. Compared with previous iterations, all three guidelines are more specific in their recommendations with respect to emergency department (ED) care. Although the principles that underpin each group's recommendations are similar, some of the details vary, which could lead to clinician confusion. In addition, no publication has compared all 3 on the care that is specific to emergency medicine, nor contextualized them with the recommendations made by 2 national emergency medicine groups. In this Concepts paper, we compare and contrast the different guidelines as they apply to the practice of emergency medicine, highlighting differences as well as the underlying rationale provided by each group. We also provide practical insights for implementation in the ED setting.