64
Treatment
10.2. Management of AF in HF
COR LOE
Recommendations
1 A 1. Patients with chronic HF with permanent-persistent-
paroxysmal AF and a CHA
2
DS
2
-VASc score of ≥2 (for men)
and ≥3 (for women) should receive chronic anticoagulant
therapy.
1 A 2. For patients with chronic HF with permanent-persistent-
paroxysmal AF, DOAC is recommended over warfarin in
eligible patients.
2a B-R 3. For patients with HF and symptoms caused by AF, AF
ablation is reasonable to improve symptoms and QOL.
2a B-R 4. For patients with AF and LVEF ≤50%, if a rhythm control
strateg y fails or is not desired, and ventricular rates remain
rapid despite medical therapy, atrioventricular nodal ablation
with implantation of a CRT device is reasonable.
2a B-NR 5. For patients with chronic HF and permanent/persistent/
paroxysmal AF, chronic anticoagulant therapy is reasonable
for men and women without additional risk factors.
11. Special Populations
11.1. Disparities and Vulnerable Populations*
COR LOE
Recommendations
1 C-LD 1. In vulnerable patient populations at risk for health disparities,
HF risk assessments and multidisciplinary management
strategies should target both known risks for CVD and social
determinants of health, as a means toward elimination of
disparate HF outcomes.
1 C-LD 2. Evidence of health disparities should be monitored and
addressed at the clinical practice and the health care system
levels.
* is section crosslinks to Section 7.1.1, "Stage C Nonpharmacological Interventions and
Self-Care Support in HF," where screening and interventions for social determinants of
health are now addressed.
