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Updated: Nov 9, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Screening and management of atrial fibrillation in primary care
Shiva P Ponamgi1, Konstantinos C Siontis2, David R Rushlow3
1Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN, USA.
Insights
Atrial fibrillation (AF) management is complex, impacting multi-morbidity and stroke risk. This review offers a model for integrating AF care components, from diagnosis to treatment, for primary care physicians.
Area of Science:
- Cardiology
- Primary Care Medicine
- Public Health
Background:
- Atrial fibrillation (AF) is a prevalent chronic condition managed across diverse healthcare settings.
- AF presents multifaceted challenges, acting as a consequence of multi-morbidity, a stroke risk factor, and an indicator of acute illness.
- Primary care physicians (PCPs) play a crucial role in navigating AF care complexities.
Purpose of the Study:
- To provide a comprehensive overview of atrial fibrillation epidemiology, screening, and risk assessment.
- To discuss management strategies for AF symptoms, including rate and rhythm control.
- To present a model for integrating various components of AF care for improved patient outcomes.
Main Methods:
- Literature review of epidemiology, screening, risk assessment, and management of atrial fibrillation.
- Analysis of current therapeutic agents and procedures for AF.
- Development of an integrated care model for atrial fibrillation.
Main Results:
- Atrial fibrillation requires a multifaceted approach considering its impact on co-existing conditions and stroke risk.
- Effective AF management involves judicious diagnostic testing and novel therapeutic options.
- Integration of care components is essential for addressing patient needs in primary care.
Conclusions:
- A coordinated approach to atrial fibrillation care is vital for optimizing patient management.
- Primary care physicians require resources and expertise to effectively manage atrial fibrillation.
- The proposed integrated model aims to streamline AF care delivery and improve clinical outcomes.
Abstract:
Atrial fibrillation is a common chronic disease seen in primary care offices, emergency departments, inpatient hospital services, and many subspecialty practices. Atrial fibrillation care is complicated and multifaceted, and, at various points, clinicians may see it as a consequence and cause of multi-morbidity, as a silent driver of stroke risk, as a bellwether of an acute medical illness, or as a primary rhythm disturbance that requires targeted treatment. Primary care physicians in particular must navigate these priorities, perspectives, and resources to meet the needs of individual patients. This includes judicious use of diagnostic testing, thoughtful use of novel therapeutic agents and procedures, and providing access to subspecialty expertise. This review explores the epidemiology, screening, and risk assessment of atrial fibrillation, as well as management of its symptoms (rate and various rhythm control options) and stroke risk (anticoagulation and other treatments), and offers a model for the integration of the components of atrial fibrillation care.
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