2025 Thai guideline for the diagnosis and management of atrial fibrillation

Abstract

Background: The Thai Cardiac Electrophysiology Club, part of the Heart Association of Thailand under the Royal Patronage of His Majesty the King, published a Clinical Practice Guideline for the Management of Patients with Atrial Fibrillation (AF) in 2012. The availability of new evidence indicates a significant need for the updating of the existing clinical practice guideline. Objectives: To serve as guidelines on the diagnosis and management of Thai patients with AF. Methods: Meetings were conducted from September 2024 to March 2025, including a public hearing that engaged various stakeholders. The final Thai version received approval in February 2025, while the English translation was completed in April 2025. Results: AF is highly prevalent. The diagnosis is crucial to detect those who need treatment for the prevention of complication. Holistic management focused on stroke prevention, symptom management, and management of cardiovascular risk factors; and comorbidity is the key success factor to maintain a good quality of life. Emerging evidence regarding newer classes of anticoagulant indicates that these treatments are effective and safe for stroke prevention. Newer catheter ablation technology has been developed and provides a better success rate and lower rate of complication. The newer stroke risk prediction CHA<inf>2</inf>DS<inf>2</inf>-VA Score is recommended for the Thai population due to its simplicity. Conclusions: The 2025 updated AF clinical practice guidelines establish a framework, provide recommendations, and serve as a comprehensive resource for the contemporary diagnosis and management of AF in the Thai population, with the goal of preventing complications.