Should emergency physicians be included in the atrial fibrillation heart team?

Atrial fibrillation is an expanding global health challenge associated with increasing prevalence, substantial morbidity, and growing healthcare costs. Most symptomatic AF encounters begin in the emergency department, yet emergency physicians are frequently excluded from formal AF "heart-team" structures. Contemporary models of AF care emphasize multidisciplinary coordination, recognizing the complex interplay of electrophysiological, structural, inflammatory, and systemic factors that influence AF onset, persistence, and long-term outcomes. Evidence demonstrates that ED-based management-particularly a decision about an early rate or rhythm control, anticoagulation decisions, and structured discharge pathways-significantly affects downstream care quality and patient safety. This editorial argues that emergency physicians are indispensable members of AF heart teams. Their inclusion enhances the integration of acute and longitudinal management, promotes guideline adherence, and addresses persistent gaps in early decision-making that shape the course of AF care.