kurskvestЧеловек и его здоровьеHumans and their health1998-57461998-5754Kursk State Medical University10.21626/vestnik/2020-4/03kurskvest-868Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEФибрилляция предсердий: обзор руководства Европейского общества кардиологов и национальных рекомендаций 2020 годаAtrial fibrillation: review of the European Society of Cardiology guidelines and national guidelines 2020https://orcid.org/0000-0002-9292-3093МещеринаНаталья СергеевнаMeshcherinaNatalia S.

д-р мед. наук, доцент, профессор кафедры внутренних болезней № 1, проректор по непрерывному образованию и международному сотрудничеству

DM, Associate Professor, Professor of the Department of Internal Diseases No. 1, Vice Rector for Continuing Education and International Cooperation

n.mescherina@yandex.ruhttps://orcid.org/0000-0001-8317-322XХардиковаЕлена МихайловнаKhardikovaElena M.

канд. мед. наук, доцент, доцент кафедры внутренних болезней № 1

PhD in Medicine, Associate Professor, Associate Professor of the Department of Internal Diseases No. 1

rx-elena@yandex.ruhttps://orcid.org/0000-0001-5856-4894СараевИгорь АнатольевичSaraevIgor A.

д-р мед. наук, профессор, профессор кафедры внутренних болезней № 2

DM, Professor, Professor of the Department of Internal Medicine No. 2

igorsarayev@yandex.ruКурский государственный медицинский университетРоссияKursk State Medical UniversityRussian Federation202025122020042129Copyright © Мещерина Н.С., Хардикова Е.М., Сараев И.А., 20202020Мещерина Н.С., Хардикова Е.М., Сараев И.А.Meshcherina N.S., Khardikova E.M., Saraev I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.kursk-vestnik.ru/jour/article/view/868

The review presents the key provisions of the recommendations of the Russian society of cardiology and the guidelines of the European society of cardiology for the diagnosis and treatment of atrial fibrillation (AF), updated in 2020. The recommendations clearly state the requirements for atrial fibrillation diagnosis verification, and propose an approach to the formation of a complex characteristic of the disease in four positions, which is designated as 4S-AF (Stroke risk, Symptom severity, Severity of AF burden, Substrate severity). The authors analyzed the strategy "CC To ABC" (Confirm AF, Characterize AF, Treat AF: the ABC pathway) proposed by European experts, the issues of modern terminology and requirements for verifying the diagnosis of AF, complex characteristics of the disease and stratification of the risk of stroke and bleeding, a new ABC approach in the treatment of AF, where A is anticoagulant prevention of thromboembolic complications, B is the control of symptoms of the disease and C is the detection and treatment of comorbid pathology. The General principles that have changed in comparison with the previous versions of guidelines of 2016 on the initiation and tactics of anticoagulant therapy, pharmacological and non-drug cardioversion, catheter ablation in patients with AF, affecting the prognosis and outcomes in patients with AF, are outlined. It is emphasized that the pattern of atrial fibrillation (first diagnosed, paroxysmal, persistent, long-term persistent, permanent) should not determine the indications for anticoagulant prevention. The solution to this issue is determined by the level of risk according to the CHA2DS2-VASc scale. The introduction of the considered methods of diagnosis and treatment of AF into clinical practice will optimize the burden on the health care system and reduce the costs associated with the burden of AF.

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The authors declare that there are no conflicts of interest present.