Flaker G, Lopes RD, Al-Khatib SM, et al. Efficacy and safety of apixa- ban in patients after cardioversion for atrial fibrillation: insights from the ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation). J Am Coll Cardiol. 2014;63:1082 7. S6.1.1-7. Cappato R, Ezekowitz MD, Klein AL, et al. Rivaroxaban vs. vitamin K antagonists for cardioversion in atrial fibrillation. Eur Heart J. 2014;35:3346 55. S6.1.1-8. Goette A, Merino JL, Ezekowitz MD, et al. Edoxaban versus enoxa- parin-warfarin in patients undergoing cardioversion of atrial fibrilla- tion (ENSURE-AF): a randomised, open-label, phase 3b trial. Lancet. 2016;388:1995 2003. S6.1.1-9. Pallisgaard JL, Lindhardt TB, Hansen ML, et al. Cardioversion and risk of adverse events with dabigatran versus warfarin a nation- wide cohort study. PLoS ONE. 2015;10:e0141377. S6.1.1-10. Plitt A, Ezekowitz MD, De Caterina R, et al. Cardioversion of atrial fibrillation in ENGAGE AF-TIMI 48. Clin Cardiol. 2016;39:345 6. S6.1.1-11. Dentali F, Botto GL, Gianni M, et al. Efficacy and safety of direct oral anticoagulants in patients undergoing cardioversion for atrial fibril- lation: a systematic review and meta-analysis of the literature. Int J Cardiol. 2015;185:72 7. S6.1.1-12. Ezekowitz MD, Pollack CV Jr, Halperin JL, et al. Apixaban com- pared to heparin/vitamin K antagonist in patients with atrial fibril- lation scheduled for cardioversion: the EMANATE trial. Eur Heart J. 2018;39:2959 71. S6.1.1-13. Airaksinen KEJ, Gr nberg T, Nuotio I, et al. Thromboembolic com- plications after cardioversion of acute atrial fibrillation: the FinCV (Finnish CardioVersion) study. J Am Coll Cardiol. 2013;62:1187 92. S6.1.1-14. Garg A, Khunger M, Seicean S, et al. Incidence of thromboembolic complications within 30 days of electrical cardioversion performed within 48 hours of atrial fibrillation onset. J Am Coll Cardiol EP. 2016;2:487 94. S6.1.1-15. Klein AL, Grimm RA, Murray RD, et al. 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S7.4-11. Crenshaw BS, Ward SR, Granger CB, et al. Atrial fibrillation in the setting of acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. J Am Coll Cardiol. 1997;30:406 13. S7.4-12. Rathore SS, Berger AK, Weinfurt KP, et al. Acute myocardial infarc- tion complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. 2000;101:969 74. S7.4-13. Goldberg RJ, Seeley D, Becker RC, et al. Impact of atrial fibrilla- tion on the in-hospital and long-term survival of patients with acute myocardial infarction: a community-wide perspective. Am Heart J. 1990;119:996 1001. S7.4-14. Behar S, Zahavi Z, Goldbourt U, et al. Long-term prognosis of patients with paroxysmal atrial fibrillation complicating acute myo- cardial infarction. SPRINT Study Group. Eur Heart J. 1992;13:45 50. S7.4-15. ACTIVE Investigators, Connolly SJ, Pogue J, et al. Effect of clopi- dogrel added to aspirin in patients with atrial fibrillation. N Engl J Med. 2009;360:2066 78. S7.4-16. You JJ, Singer DE, Howard PA, et al. Antithrombotic therapy for atrial fibrillation: antithrombotic therapy and prevention of throm- bosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141:e531S 75S. S7.4-17. Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138:1093 100. S7.4-18. Lopes RD, Rordorf R, De Ferrari GM, et al. Digoxin and mortality in patients with atrial fibrillation. J Am Coll Cardiol. 2018;71:1063 74. CLINICAL STATEMENTS AND GUIDELINES S7.4-19. Vamos M, Erath JW, Hohnloser SH. Digoxin-associated mortality: a systematic review and meta-analysis of the literature. Eur Heart J. 2015;36:1831 8. S7.4-20. Pedersen OD, Bagger H, K ber L, et al. The occurrence and prog- nostic significance of atrial fibrillation/-flutter following acute myocardial infarction. TRACE Study group. TRAndolapril Cardiac Evaluation. Eur Heart J. 1999;20:748 54. S7.4-21. McMurray J, K ber L, Robertson M, et al. Antiarrhythmic effect of carvedilol after acute myocardial infarction: results of the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) trial. J Am Coll Cardiol. 2005;45:525 30. S7.4-22. Fauchier L, Lecoq C, Ancedy Y, et al. Evaluation of 5 prognostic scores for prediction of stroke, thromboembolic and coronary events, all-cause mortality, and major adverse cardiac events in patients with atrial fibrillation and coronary stenting. Am J Cardiol. 2016;118:700 7. S7.4 23. lvarez- lvarez B, Raposeiras-Roub n S, Abu-Assi E, et al. Is 6-month GRACE risk score a useful tool to predict stroke after an acute coro- nary syndrome? Open Heart. 2014;1:e000123. S7.4-24. Bristol-Myers Squibb. A study of apixaban in patients with atrial fibrillation, not caused by a heart valve problem, who are at risk for thrombosis (blood clots) due to having had a recent coronary event, such as a heart attack or a procedure to open the vessels of the heart. Available at: https://www.clinicaltrials.gov. Identifier: NCT02415400. Accessed November 1, 2017. S7.4-25. Daiichi Sankyo, Inc. Edoxaban treatment versus vitamin K antago- nist in patients with atrial fibrillation undergoing percutaneous coronary intervention (ENTRUST-AF-PCI). Available at: https://www. clinicaltrials.gov. Identifier: NCT02866175. Accessed November 1, 2017. 7.12. Device Detection of AF and Atrial Flutter (New Section) S7.12-1. Boriani G, Glotzer TV, Santini M, et al. Device-detected atrial fibrillation and risk for stroke: an analysis of >10 000 patients from the SOS AF project (Stroke prevention Strategies based on Atrial Fibrillation information from implanted devices). Eur Heart J. 2014;35:508 16. S7.12-2. Glotzer TV, Daoud EG, Wyse DG, et al. The relationship between daily atrial tachyarrhythmia burden from implantable device diagnostics and stroke risk: the TRENDS study. Circ Arrhythm Electrophysiol. 2009;2:474 80. S7.12-3. Glotzer TV, Hellkamp AS, Zimmerman J, et al. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST). Circulation. 2003;107:1614 9. S7.12-4. Healey JS, Connolly SJ, Gold MR, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366:120 9. S7.12-5. Martin DT, Bersohn MM, Waldo AL, et al. Randomized trial of atrial arrhythmia monitoring to guide anticoagulation in patients with implanted defibrillator and cardiac resynchronization devices. Eur Heart J. 2015;36:1660 8. S7.12-6. Sanna T, Diener H-C, Passman RS, et al. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014;370:2478 86. S7.12-7. Halcox JPJ, Wareham K, Cardew A, et al. Assessment of remote heart rhythm sampling using the AliveCor heart monitor to screen for atrial fibrillation: the REHEARSE-AF Study. Circulation. 2017;136:1784 94. S7.12-8. Bumgarner JM, Lambert CT, Hussein AA, et al. Smartwatch algo- rithm for automated detection of atrial fibrillation. J Am Coll Cardiol. 2018;71:2381 8. 7.13. Weight Loss (New Section) S7.13-1. Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310:2050 60. S7.13-2. Pathak RK, Middeldorp ME, Lau DH, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the out- come of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64:2222 31. S7.13-3. Pathak RK, Middeldorp ME, Meredith M, et al. Long-term effect of goal-directed weight management in an atrial fibrillation cohort: a long-term follow-up study (LEGACY). J Am Coll Cardiol. 2015;65:2159 69. S7.13-4. Abed HS, Samuel CS, Lau DH, et al. Obesity results in progressive atrial structural and electrical remodeling: implications for atrial fibrillation. Heart Rhythm. 2013;10:90 100. S7.13-5. Wang TJ, Parise H, Levy D, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292:2471 7. S7.13-6. Wong CX, Ganesan AN, Selvanayagam JB. Epicardial fat and atrial fibrillation: current evidence, potential mechanisms, clinical implica- tions, and future directions. Eur Heart J. 2017;38:1294 302. S7.13-7. Wong CX, Abed HS, Molaee P, et al. Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol. 2011;57:1745 51. S7.13-8. Middeldorp ME, Pathak RK, Meredith M, et al. PREVEntion and regReSsive Effect of weight-loss and risk factor modification on Atrial Fibrillation: the REVERSE-AF study. Europace. 2018;20:1929 35. CLINICAL STATEMENTS AND GUIDELINES Appendix 1. Author Relationships With Industry and Other Entities (Relevant) 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (July 2018) Committee Member Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Voting Recusals by Section* Craig T. January Chair University of Wisconsin- Madison Professor of Medicine, Cardiovascular Medicine Division None None None None None None None L. Samuel Wann Vice Chair Columbia St. Mary s Cardiovascular Physicians Clinical Cardiologist Astellas None None None None None None Hugh Calkins Johns Hopkins Hospital Professor of Medicine, Director of Electrophysiology Abbott AltaThera AtriCure Boehringer Ingelheim King Pharmaceuticals, Inc. (Pfizer) Medtronic St. Jude Medical None None Boehringer Ingelheim Boston Scientific St. Jude Medical Lin Y. Chen University of Minnesota Medical School, Cardiovascular Division Associate Professor of Medicine None None None None None None None Joaquin E. Cigarroa Oregon Health & Science University Professor of Medicine; Clinical Chief of Knight Cardiovascular Institute Division Head of Cardiology None None None None None None None Joseph C. Cleveland, Jr University of Colorado Professor of Surgery; Denver Veteran s Administration Hospital Chief, Cardiac Surgery None None None St. Jude Medical None None 4.4.1, 4.4.2, 6.3.4, Patrick T. Ellinor Massachusetts General Hospital Heart Center, Cardiac Arrhythmia Service Director Bayer None None Bayer None None 4.1.1, 4.2.2.2, 4.3, Michael D. Ezekowitz Sidney Kimmel Medical College at Thomas Jefferson University Professor of Medicine; Lankenau Medical Center, Bryn Mawr Hospital Attending Cardiologist Armetheon Bayer Boehringer Ingelheim Bristol-Myers Squibb Coherex Daiichi-Sankyo Janssen Pharmaceuticals Johnson & Johnson Medtronic Merck Pfizer Portola Pharmaceuticals Sanofi-aventis None None Boehringer Ingelheim (PI) Pfizer (PI) Portola Pharmaceuticals Michael E. Field Medical University of South Carolina and Ralph H. Johnson VA Medical Center Associate Professor of Medicine None None None None None None None Karen L. Furie Rhode Island Hospital, the Miriam Hospital and Bradley Hospital Neurologist-in-Chief; The Warren Alpert Medical School of Brown University Chair of Neurology None None None None None None None Paul A. Heidenreich Stanford VA Palo Alto Health Care System Professor of Medicine None None None None None None None Katherine T. Murray Vanderbilt University School of Medicine, Divisions of Clinical Pharmacology and Cardiology Professor of Medicine None None Metabolic Technologies, Inc. None None None None Julie B. Shea Brigham and Women s Hospital Medtronic St. Jude Medical None None None None None 4.4.1, 4.4.2, 7.4, (Continued) CLINICAL STATEMENTS AND GUIDELINES Cynthia M. Tracy George Washington University Medical Center Associate Director and Professor of Medicine None None None None None None None Clyde W. Yancy Northwestern University, Feinberg School of Medicine Magerstadt Professor of Medicine; Division of Cardiology Chief None None None None None None None This table represents the relationships of committee members with industry and other entities that were determined to be relevant to this document. These relationships were reviewed and updated in conjunction with all meetings and/or conference calls of the writing committee during the document development process. The table does not necessarily reflect relationships with industry at the time of publication. A person is deemed to have a significant interest in a business if the interest represents ownership of 5% of the voting stock or share of the business entity, or ownership of $5000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person s gross income for the previous year. Relationships that exist with no financial benefit are also included for the purpose of transparency. Relationships in this table are modest unless otherwise noted. According to the ACC/AHA, a person has a relevant relationship IF: a) the relationship or interest relates to the same or similar subject matter, intellectual property or asset, topic, or issue addressed in the document; or b) the company/entity (with whom the relationship exists) makes a drug, drug class, or device addressed in the document, or makes a competing drug or device addressed in the document; or c) the person or a member of the person s household, has a reasonable potential for financial, professional or other personal gain or loss as a result of the issues/content addressed in the document. The Atrial Fibrillation Guideline was initiated in September 2016. Over the initial years of the CMS Open Payment System, understandably, there have been many issues related to the accurate reporting of food and beverage payments. For this reason, the ACC and AHA have not considered these minor charges relevant relationships with industry. *Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply. Significant relationship. No financial benefit. CMS reported payments related to medical education from Medtronic Vascular to a third party, University of Minnesota Foundation, under Dr. Chen s name in 2016. Medtronic has confirmed that there was no payment made to Dr. Chen, and the entry was made in error. The sections authored by Dr. Chen have been reviewed, and it was affirmed that there was no implication of any influence of industry. ACC indicates American College of Cardiology; AHA, American Heart Association; CMS, Centers for Medicare & Medicaid Services; HRS, Heart Rhythm Society; PI, principal investigator; and VA, Veterans Affairs. Appendix 1. Continued Committee Member Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Voting Recusals by Section* CLINICAL STATEMENTS AND GUIDELINES Appendix 2. Abbreviated Reviewer Relationships With Industry and Other Entities 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/ HRS Guideline for the Management of Patients With Atrial Fibrillation (August 2018)* Reviewer Representation Employment Comprehensive RWI? Samuel C. Dudley, Jr Official Reviewer AHA University of Minnesota Director, Cardiology Division Yes Federico Gentile Official Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Centro Cardiologico Gentile No Augustus O. Grant Official Reviewer AHA Duke University School of Medicine Professor of Medicine; Vice Dean, Faculty Enrichment No Eric Stecker Official Reviewer ACC Science and Quality Committee OHSU Associate Professor of Medicine, Division of Cardiovascular Medicine, School of Medicine Yes Eugene Yang Official Reviewer ACC Board of Governors University of Washington School of Medicine Yes James R. Edgerton Organizational Reviewer STS The Heart Hospital Baylor Director of Education Yes Fred Morady Organizational Reviewer HRS University of Michigan McKay Professor of Cardiovascular Disease and Professor of Medicine Yes Hakan Oral Organizational Reviewer HRS University of Michigan Hospital Frederick G. L. Huetwell Professor of Cardiovascular Medicine; Director, Cardiac Arrhythmia Service Yes Sana M. Al-Khatib Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Duke Clinical Research Institute Professor of Medicine Yes Joseph S. Alpert Content Reviewer University of Arizona Health Sciences Center Professor of Medicine; Head, Department of Medicine Yes Anastasia L. Armbruster Content Reviewer ACC Surgeons Council St. Louis College of Pharmacy Associate Professor, Department of Pharmacy Practice No Nisha Bansal Content Reviewer University of Washington Associate Professor, Division of Nephrology; Associate Program Director, Nephrology Fellowship Yes Coletta Barrett Content Reviewer AHA/ACC Lay Reviewer Our Lady of the Lake Regional Medical Center Vice President, Mission No Kim K. Birtcher Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines University of Houston College of Pharmacy Clinical Professor Yes John A. Bittl Content Reviewer Ocala Heart Institute; Munroe Regional Medical Center No Yong-Mei Cha Content Reviewer Mayo Clinic, Division of Cardiovascular Diseases No Jamie B. Conti Content Reviewer University of Florida Professor of Medicine (Cardiology); Chief, Division of Cardiovascular Diseases, Department of Medicine Yes Anita Deswal Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Baylor College of Medicine Professor of Medicine; Michael E. DeBakey VA Medical Center Chief of Cardiology Yes Michael S. Firstenberg Content Reviewer ACC Surgeons Council The Summa Health System Yes Zachary D. Goldberger Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines University of Wisconsin School of Medicine and Public Health Associate Professor of Medicine, Division of Cardiovascular Medicine/Electrophysiology No Maya E. Guglin Content Reviewer ACC HF and Transplant Section Leadership Council University of Kentucky Professor of Medicine; Director, Mechanical Assisted Circulation, Gill Heart Institute Yes Jonathan L. Halperin Content Reviewer Mount Sinai Medical Center Professor of Medicine Yes Jos A. Joglar Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines UT Southwestern Medical Center University Associate Professor of Internal Medicine No Gautam Kumar Content Reviewer ACC Interventional Section Leadership Council Emory University; Atlanta VA Medical Center Yes Valentina Kutyifa Content Reviewer ACC EP Section Leadership Council University of Rochester Medical Center Associate Professor of Medicine Yes Glenn N. Levine Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Baylor College of Medicine Professor of Medicine; Michael E. DeBakey Medical Center Director, Cardiac Care Unit Yes Grace Lin Content Reviewer ACC HF and Transplant Section Leadership Council Mayo Clinic; Mayo Foundation Yes Gregory Y. H. Lip Content Reviewer University of Birmingham Centre For Cardiovascular Sciences Yes (Continued) CLINICAL STATEMENTS AND GUIDELINES Patrick T. O Gara Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Harvard Medical School Prof of Medicine; Brigham and Women s Hospital Director, Strategic Planning Yes Ratika Parkash Content Reviewer Dalhousie University and Nova Scotia Health Authority Professor of Medicine, Division of Cardiology (Arrhythmia); Director of Research, Division of Cardiology Yes Mariann Piano Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Vanderbilt University School of Nursing Nancy and Hilliard Travis Professor of Nursing; Senior Associate Dean for Research Yes Win-Kuang Shen Content Reviewer Mayo Clinic Arizona, Phoenix Campus Professor of Medicine; Consultant No Giuseppe Stabile Content Reviewer Clinica Mediterranea, Naples, Italy Yes William G. Stevenson Content Reviewer Vanderbilt Medical Center Director, Director of Arrhythmia Research Yes James Tisdale Content Reviewer AHA Purdue University Professor, College of Pharmacy; Indiana University School of Medicine Adjunct Professor Yes Shane Tsai Content Reviewer ACC Adult Congenital and Pediatric Cardiology Section Leadership Council University of Nebraska Medical Center Assistant Professor, Internal Medicine and Pediatrics, Division of Cardiovascular Medicine; Section Chief, Electrophysiology Yes Kathryn Wood Content Reviewer AHA Emory University Associate Professor, Nell Hodgson Woodruff School of Nursing No This table represents all relationships of reviewers with industry and other entities that were reported at the time of peer review, including those not deemed to be relevant to this document, at the time this document was under review. The table does not necessarily reflect relationships with industry at the time of publication. A person is deemed to have a significant interest in a business if the interest represents ownership of 5% of the voting stock or share of the business entity, or ownership of $5000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person s gross income for the previous year. Relationships that exist with no financial benefit are also included for the purpose of transparency. Relationships in this table are modest unless otherwise noted. Names are listed in alphabetical order within each category of review. Please refer to http://www.acc.org/guidelines/ about-guidelines-and-clinical-documents/relationships-with-industry-policy for definitions of disclosure categories or additional information about the ACC/AHA Disclosure Policy for Writing Committees. *Detailed reviewer disclosures can be found at this link: https://www.ahajournals.org/doi/suppl/10.1161/CIR.0000000000000665. ACC indicates American College of Cardiology; AHA, American Heart Association; EP, electrophysiology; HF, heart failure; HRS, Heart Rhythm Society; OHSU, Oregon Health & Science University; RWI, relationships with industry and other entities; STS, Society of Thoracic Surgeons; UT, University of Texas; and VA, Veterans Affairs. Appendix 2. Continued Reviewer Representation Employment Comprehensive RWI?