Recommendation 1 – Complete history and physical examination (2010)
All patients with atrial fibrillation should undergo a complete history and physical examination, electrocardiogram, echocardiogram, and basic laboratory investigations. Details are highlighted in Table 1 (Strong Recommendation; Low Quality Evidence). Other ancillary tests should be considered under specific circumstances. Details included in Table 2 (Strong Recommendation; Low Quality Evidence).

Values and preferences (2010)
This recommendation places a high value on a comprehensive evaluation of patients with AF and a lower value on initial costs to the health care system.

Recommendation 2 – Well-being, symptoms, and quality of life (2010)
We recommend that the assessment of patient well-being, symptoms, and quality of life be part of the evaluation of every patient with AF (Strong Recommendation, Low Quality Evidence).

Recommendation 3 – Quality of life – CCS-AF scale (2010)
We suggest that the quality of life of the AF patient be assessed in routine care using the CCS SAF scale (Conditional Recommendation, Low Quality Evidence).

Values and preferences (2010)
Recommendations 2 and 3 recognize that improvement in quality of life is a high priority for therapeutic decision making.

Recommendation 4 - Identification of underlying causes or precipitating factors (2010)
Underlying causes or precipitating factors for AF including hypertension should be identified and treated. Details are highlighted in Table 3 (Strong Recommendation; High Quality of Evidence).

Values and preferences (2010)
This recommendation recognizes that therapy of underlying etiology can improve management of AF and that failure to recognize underlying factors may result in deleterious effects.

Recommendation 5 - Management of modifiable risk factors to reduce cardiovascular events (2018)
We recommend systematic and strict guideline adherent management of traditional modifiable cardiovascular risk factors and/or conditions associated with AF, in order to reduce cardiovascular events (e.g. stroke, MI, etc.) (Strong Recommendation, High Quality Evidence).

Values and preferences (2018)
This recommendation places a high value on a systematic approach to providing guideline-directed therapy for any cardiovascular risk factors and/or conditions associated with AF.

Practical tip (2018)
The detection and optimal management of risk factors and concomitant together with appropriate rate/rhythm control and stroke prevention may contribute to a reduction in cardiovascular-related emergency department visits and hospitalizations. Addressing such risk factors might be most comprehensively and efficiently accomplished through a specialized clinic or other multidisciplinary management approach, and through a standardized, systematic protocol-based approach.

Recommendation 6 - Management of modifiable risk factors to reduce AF burden (2018)
We suggest that, in addition to implementing appropriate rate or rhythm control measures, an approach targeting modifiable risk markers and conditions associated with AF should be applied, to prevent recurrence of the arrhythmia and/or decrease its symptom burden (Weak Recommendation, Low Quality Evidence).

Values and preferences (2018)
The aggressive treatment of obesity and cardiometabolic risk markers/conditions (including hypertension, heart failure, diabetes, sleep apnea) has been shown to reduce AF burden and improve quality of life. This recommendation places a high value on the recognized association between these potential risk markers and conditions that are known to aggravate AF and the possibility that treatment of these may result in prevention and/or progression of the substrate that causes AF as well as improving patient symptoms.