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Management
10.1. Management of Early Onset AF, Including Genetic
Testing
COR LOE
Recommendations
2b B-NR 1. In patients with an onset of unexplained AF before the age
of 30 years, electrophysiologic study to evaluate and treat
reentrant supraventricular tachyarrhythmias with a targeted
ablation may be reasonable in view of the high prevalence of
reentrant arrhythmias in this group.
2b B-NR 2. In patents with an onset of AF before the age of 45 years
without obvious risk factors for AF, referral for genetic
counseling, genetic testing for rare pathogenic variants, and
surveillance for cardiomyopathy or arrhythmia syndromes
may be reasonable.
10.4. Anticoagulation Considerations in Patients With Class
III Obesity
COR LOE
Recommendations
2a B-NR 1. In patients with AF and class III obesity (BMI ≥40 kg/m
2
),
DOACs are reasonable to choose over warfarin for stroke risk
reduction.
2b C-LD 2. In patients with AF who have undergone bariatric surgery,
warfarin may be reasonable to choose over DOACs for
stroke risk reduction in view of concerns about DOAC drug
absorption.
10.2. Athletes
COR LOE
Recommendation
2a B-NR 1. In athletes who develop AF, catheter ablation with PVI
is a reasonable strateg y for rhythm control in view of its
effectiveness and low risk of detrimental effect on exercise
capacity.
10. AF and Specific Patient Groups
10.3. Management Considerations in Patients With AF and
Obesity
