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Pathway for the Management of Atrial Fibrillation and Atrial Flutter

Herzog, Eyal MD; Argulian, Edgar MD; Levy, Steven B. PharmD; Aziz, Emad F. DO, MBChB

Critical Pathways in Cardiology: June 2017 - Volume 16 - Issue 2 - p 47–52
doi: 10.1097/HPC.0000000000000109

Atrial fibrillation (AF) is the most common cardiac rhythm disturbance encountered in clinical practice, and its prevalence is increasing as the population ages. The American College of Cardiology, the American Heart Association, and the European Society of Cardiology established guidelines for the management of patients with AF. Atrial flutter (Afl) is less common and is often associated with or preceded by AF or occurs in an isolated pattern. A major limitation of the currently published guidelines for the management of patients with AF and Afl is their complexity, the fact that official guidelines are published separately for each of these arrhythmias, and that they were published several years ago. To address these deficiencies, we have developed a novel pathway for the management of AF and Afl. The pathway has been designated with the acronym RACE, which reflects the 4 main components in patient management: rate control, anticoagulation therapy, cardioversion, and electrophysiology/antiarrhythmic medication. This pathway is an attempt to incorporate, in a user-friendly format, the key concepts of the initial diagnosis and management of these prevalent arrhythmias. This is followed by a comprehensive guideline for therapy using the RACE acronym.

From the Mount Sinai St. Luke’s Hospital, New York, NY.

Received for publication January 5, 2016; accepted January 5, 2017.

Reprints: Eyal Herzog, MD, Mount Sinai St. Luke’s Hospital, New York, NY. E-mail:

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