Atrial Fibrillation Occurring During Acute Hospitalization: A Scientific Statement From the American Heart Association

Acute AF carries high risk of long-term recurrence, warranting clinical attention during acute hospitalization and over long-term follow-up

A framework of substrates and triggers can be useful for evaluating and managing acute AF

Acute management: multipronged, interdisciplinary, tailored to underlying substrate and acute condition; key components are identifying and treating triggers, rate/rhythm control and anticoagulation

Acute rate or rhythm control should be individualized to the patient's capacity to tolerate rapid rates or atrioventricular dyssynchrony and the risk of the therapeutic strategy

Clinical follow-up and heart rhythm monitoring are warranted given high AF recurrence risk

Long-term management is guided by patient substrate (intensity of rhythm monitoring, anticoagulation, rhythm management strategies)

3As of acute management: acute triggers, AF rate/rhythm management, anticoagulation; 2As and 2Ms of long-term management: rhythm monitoring and lifestyle/risk-factor modification, plus rate/rhythm management and anticoagulation