# 2023 ACC/AHA/ACCP/HRS atrial fibrillation guideline Guideline · id `cardio:guideline-acc-aha-2023-af` · Cardiovascular Atlas · release `5dcd9b263fe17744` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, organ or system: Heart Browse, condition area: Heart rhythm problems ## In plain language The 2023 guideline on diagnosing and managing atrial fibrillation from the American College of Cardiology and the American Heart Association, with two more societies abbreviated in its title (ACCP and HRS). Its abstract says it updates recommendations from the 2014 guideline and the 2019 focused update, and adds new ones on thromboembolic risk, anticoagulation, left atrial appendage occlusion, ablation, and risk factor modification and AF prevention. The stroke prevention points on this site come from an ACC summary because the guideline text was not read. ## Technical summary Circulation 2024;149(1):e1-e156, doi 10.1161/CIR.0000000000001193, PMID 38033089. Electronic publication 2023-11-30. Issued by the joint ACC/AHA committee on clinical practice guidelines. HRS has no record in this atlas. A PMC author manuscript (PMC11095842) exists but is not in the PMC Open Access subset, so it was not fetched. PubMed lists three corrections (2024-01-02, 2024-02-27 and 2024-06-11); their text was not read. ## Claims, with the population each applies to ## Context: Patients with atrial fibrillation (ACC summary of the 2023 guideline) Recipient: Recipient not specified; Population: Patients with atrial fibrillation. The ACC summary gives no age limits and, apart from the exceptions each claim names, no exclusions.; Care setting: Not stated in the ACC summary.; Geography: Not stated in the ACC summary (issued by American societies; jurisdiction not verified); Life stage: Not stated in the ACC summary; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guideline context) ### An ACC summary of the 2023 ACC/AHA atrial fibrillation guideline says that for patients whose estimated yearly chance of a stroke or thromboembolic event is 2% or more, therapy to lower stroke risk should follow that thromboembolic risk, whatever the AF pattern (paroxysmal, persistent, long-standing persistent and permanent alike). - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Recipient not specified; Population: Patients with atrial fibrillation. The ACC summary gives no age limits and, apart from the exceptions each claim names, no exclusions.; Care setting: Not stated in the ACC summary.; Geography: Not stated in the ACC summary (issued by American societies; jurisdiction not verified); Life stage: Not stated in the ACC summary; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guideline context) - Limitations: The source is the ACC key-perspectives summary of the guideline (ACC content, hash only), not the guideline text. The summary says stroke-reducing therapy, not oral anticoagulants by name, in this statement, so no recommendation record is written for it. It prints no class of recommendation for this statement, and it gives the treatment for lower-risk patients in text that could not be quoted. PubMed lists three corrections to the guideline (2024-01-02, 2024-02-27 and 2024-06-11); their text was not read, so it is not known whether they change anything stated here. - Last checked: 2026-10-15 - Source problem: a cited source is corrected. Check the sources before relying on this claim. - Sources: 1. Supports: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines (Guideline, edition Published in Circulation 149(1):e1-e156 (issue date 2024-01-02; electronic publication 2023-11-30). PubMed abstract and bibliographic data only. PMC lists an author manuscript (PMC11095842) that is not in the PMC Open Access subset, so it was not fetched. The guideline text was not read. PubMed lists 3 corrections to the guideline; their text was not read. The same source also holds a snapshot of the ACC key-perspectives summary page (dated Nov 30, 2023), an ACC summary and not the guideline text. In the page markup some less-than symbols hide the text that follows them, so only passages free of such symbols are quoted. The publisher field is the journal title as PubMed gives it.) Locator: Key perspective 4, sentence 2, fragments 1 to 3. Retrieved 2026-10-15T13:52:56Z. Source state: Corrected. Snapshot hash: 351ef6a153a9922b720e0ea62e3c8ccb64abd9945012b3992bb58528d3446453. How it applies: Stroke-reducing therapy follows thromboembolic risk, not AF pattern, at an annual risk of 2% or more. 2. Background: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines (Guideline, edition Published in Circulation 149(1):e1-e156 (issue date 2024-01-02; electronic publication 2023-11-30). PubMed abstract and bibliographic data only. PMC lists an author manuscript (PMC11095842) that is not in the PMC Open Access subset, so it was not fetched. The guideline text was not read. PubMed lists 3 corrections to the guideline; their text was not read. The same source also holds a snapshot of the ACC key-perspectives summary page (dated Nov 30, 2023), an ACC summary and not the guideline text. In the page markup some less-than symbols hide the text that follows them, so only passages free of such symbols are quoted. The publisher field is the journal title as PubMed gives it.) Locator: CommentsCorrectionsList, three ErratumIn entries. Retrieved 2026-10-15T13:48:58Z. Source state: Corrected. Snapshot hash: 3ee3998a9178e8f21223e2388261924207d5e1f8fb19bf34e8355e11eb2c07a9. How it applies: Shows that corrections exist. What they change is unknown. ### An ACC summary of the 2023 ACC/AHA atrial fibrillation guideline says the guideline endorses using a validated clinical risk score to estimate stroke and thromboembolism risk; it gives CHA2DS2-VASc, ATRIA and GARFIELD-AF as examples. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Recipient not specified; Population: Patients with atrial fibrillation. The ACC summary gives no age limits and, apart from the exceptions each claim names, no exclusions.; Care setting: Not stated in the ACC summary.; Geography: Not stated in the ACC summary (issued by American societies; jurisdiction not verified); Life stage: Not stated in the ACC summary; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guideline context) - Limitations: The source is the ACC key-perspectives summary of the guideline (ACC content, hash only), not the guideline text. The summary names three scores as examples and does not rank them. It gives no class of recommendation for this statement. PubMed lists three corrections to the guideline (2024-01-02, 2024-02-27 and 2024-06-11); their text was not read, so it is not known whether they change anything stated here. - Last checked: 2026-10-15 - Source problem: a cited source is corrected. Check the sources before relying on this claim. - Sources: 1. Supports: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines (Guideline, edition Published in Circulation 149(1):e1-e156 (issue date 2024-01-02; electronic publication 2023-11-30). PubMed abstract and bibliographic data only. PMC lists an author manuscript (PMC11095842) that is not in the PMC Open Access subset, so it was not fetched. The guideline text was not read. PubMed lists 3 corrections to the guideline; their text was not read. The same source also holds a snapshot of the ACC key-perspectives summary page (dated Nov 30, 2023), an ACC summary and not the guideline text. In the page markup some less-than symbols hide the text that follows them, so only passages free of such symbols are quoted. The publisher field is the journal title as PubMed gives it.) Locator: Key perspective 3, sentence 1. Retrieved 2026-10-15T13:52:56Z. Source state: Corrected. Snapshot hash: 351ef6a153a9922b720e0ea62e3c8ccb64abd9945012b3992bb58528d3446453. How it applies: A validated clinical risk score is endorsed; three examples. 2. Background: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines (Guideline, edition Published in Circulation 149(1):e1-e156 (issue date 2024-01-02; electronic publication 2023-11-30). PubMed abstract and bibliographic data only. PMC lists an author manuscript (PMC11095842) that is not in the PMC Open Access subset, so it was not fetched. The guideline text was not read. PubMed lists 3 corrections to the guideline; their text was not read. The same source also holds a snapshot of the ACC key-perspectives summary page (dated Nov 30, 2023), an ACC summary and not the guideline text. In the page markup some less-than symbols hide the text that follows them, so only passages free of such symbols are quoted. The publisher field is the journal title as PubMed gives it.) Locator: CommentsCorrectionsList, three ErratumIn entries. Retrieved 2026-10-15T13:48:58Z. Source state: Corrected. Snapshot hash: 3ee3998a9178e8f21223e2388261924207d5e1f8fb19bf34e8355e11eb2c07a9. How it applies: Shows that corrections exist. What they change is unknown. ## Connected pages - Co-issuer, with the American Heart Association (title): American College of Cardiology (`core:acc`) - Co-issuer, with the American College of Cardiology (title): American Heart Association (`core:aha`) - Representative of the American College of Clinical Pharmacy on the writing committee (author affiliation); the title abbreviates the college as ACCP: American College of Clinical Pharmacy (`cardio:accp`) ## Provenance Content hash: c1889f7ac7cb7e8e62228f5da230fa427ef72398689fe96526c867ea6cac71ae Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-15