WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Lorena de Sá Pereira*, Carolina Baptista Amorim Rocha, Jean Fialho Fazolo de Souza, Wylisson Marcelo Almeida Lins

ABSTRACT

Acute atrial fibrillation (AF) is a common clinical emergency associated with increased morbidity, mortality, and hospitalizations. This study aims to critically review and compare the most recent updates (2022–2025) from the American (ACC/AHA/HRS), European (ESC), and Brazilian (SBC) guidelines for the management of acute AF. Through a narrative literature review, differences were analyzed regarding strategies for rate versus rhythm control, anticoagulation, cardioversion, blood pressure targets, and catheter ablation indications. Although the guidelines share common evidence-based principles, they diverge on key aspects, such as anticoagulation initiation criteria and early Indications for cardioversion or ablation. The European guidelines tend to adopt earlier and more aggressive approaches, whereas the American and Brazilian guidelines prioritize more conservative strategies adapted to local contexts. It is concluded that individualized treatment, combined with the implementation of updated guidelines tailored to each healthcare system's reality, is essential to improve clinical outcomes in patients with acute AF.