The 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Comprehensive Guidelines for the Management of Atrial Fibrillation

Can J Cardiol. 2020 Dec;36(12):1847-1948. doi: 10.1016/j.cjca.2020.09.001. Epub 2020 Oct 22.


The Canadian Cardiovascular Society (CCS) atrial fibrillation (AF) guidelines program was developed to aid clinicians in the management of these complex patients, as well as to provide direction to policy makers and health care systems regarding related issues. The most recent comprehensive CCS AF guidelines update was published in 2010. Since then, periodic updates were published dealing with rapidly changing areas. However, since 2010 a large number of developments had accumulated in a wide range of areas, motivating the committee to complete a thorough guideline review. The 2020 iteration of the CCS AF guidelines represents a comprehensive renewal that integrates, updates, and replaces the past decade of guidelines, recommendations, and practical tips. It is intended to be used by practicing clinicians across all disciplines who care for patients with AF. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to evaluate recommendation strength and the quality of evidence. Areas of focus include: AF classification and definitions, epidemiology, pathophysiology, clinical evaluation, screening and opportunistic AF detection, detection and management of modifiable risk factors, integrated approach to AF management, stroke prevention, arrhythmia management, sex differences, and AF in special populations. Extensive use is made of tables and figures to synthesize important material and present key concepts. This document should be an important aid for knowledge translation and a tool to help improve clinical management of this important and challenging arrhythmia.

Publication types

  • Practice Guideline

MeSH terms

  • Aged, 80 and over
  • Anticoagulants* / administration & dosage
  • Anticoagulants* / adverse effects
  • Atrial Fibrillation* / classification
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / therapy
  • Canada / epidemiology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / therapy
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / methods
  • Female
  • Heart Disease Risk Factors
  • Hemorrhage* / chemically induced
  • Hemorrhage* / prevention & control
  • Humans
  • Male
  • Middle Aged
  • Patient Care Management* / methods
  • Patient Care Management* / standards
  • Prevalence
  • Risk Adjustment / methods
  • Risk Adjustment / standards
  • Societies, Medical
  • Stroke* / etiology
  • Stroke* / prevention & control


  • Anticoagulants