NICE quality standard on AF

Br J Cardiol 2015;22:89–90 Leave a comment
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The National Institute of Health and Care Excellence (NICE) has published a new quality standard on the treatment and management of atrial fibrillation (AF) in adults.

Dr Matthew Fay, a Bradford GP and specialist member of the committee that developed the standard, said: “This quality standard brings into sharp focus the key issue of stroke prevention. In doing so it continues to highlight the need for a change in practice so that everyone with AF is considered for anticoagulation and the quality of that anticoagulation is always kept under review by clinicians and commissioning groups.”

The quality standard includes six statements aimed at healthcare professionals caring for people in danger of developing, or who already have, AF. These include:

  • Adults with a type of AF called ‘non-valvular’ who have a stroke risk score of 2 or more (as estimated by their doctor using the CHA2DS2-VASC risk score) are offered treatment with an anticoagulant to lower their risk of having a blood clot that could cause a stroke.
  • Adults with AF who are prescribed an anticoagulant talk with their doctor at least once a year about the types of anticoagulants they could have and the advantages and disadvantages of each.
  • Adults with AF who are taking a vitamin K antagonist have regular blood tests to check whether the dose they are taking is at the right level to reduce their risk of stroke and bleeding problems.
  • Adults with AF who still have symptoms after treatment are referred within four weeks for specialised care that aims to ease their symptoms and reduce their risk of having a stroke or heart attack.

The quality standard also includes NICE’s first developmental statement on the provision and use of coagulometers for people on long-term vitamin K antagonist therapy, so they can check how well the treatment is working.

Full guidance is available at