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4.2.2. Rhythm Monitoring Tools and Methods
COR LOE
Recommendations
1 B-NR 1. Among individuals without a known history of AF,
it is recommended that an initial AF diagnosis be
made by a clinician using visual interpretation of the
electrocardiographic signals, regardless of the type of rhythm
or monitoring device.
1 B-NR 2. In patients with an intracardiac rhythm device capable of
a diagnosis of AF, such as from an atrial pacemaker lead,
a diagnosis of AF should only be made after it is visually
confirmed by reviewing intracardiac tracings in order to
exclude signal artifacts and other arrhythmias.
2a B-R 3. For patients who have had a systemic thromboembolic event
without a known history of AF and in whom maximum
sensitivity to detect AF is sought, an implantable cardiac
monitor is reasonable.
2a B-NR 4. Among patients with a diagnosis of AF, it is reasonable to
infer AF frequency, duration, and burden using automated
algorithms available from electrocardiographic monitors,
implantable cardiac monitors, and cardiac rhythm devices
with an atrial lead, recognizing that periodic review can be
required to exclude other arrythmias.
2a B-R 5. Among patients with AF in whom cardiac monitoring is
advised, it is reasonable to recommend use of a consumer-
accessible electrocardiographic device that provides a high-
quality tracing to detect recurrences.
5.1. Primary Prevention
COR LOE
Recommendation
1 B-NR 1. Patients at increased risk of AF should receive comprehensive
guideline-directed LRFM for AF, targeting obesity, physical
inactivity, unhealthy alcohol consumption, smoking, diabetes,
and hypertension.
5. Lifestyle and Risk Factor Modification for AF Management