Acute atrial fibrillation management (adult UK pathway)
A source-linked educational visual of acute adult atrial fibrillation assessment, instability, rate control and cardioversion considerations from NICE NG196.
Important safety note
This visual algorithm is an educational representation of published UK clinical guidance and is not a substitute for clinical judgement, local protocols, senior/specialist advice, or the original guideline. Verify current guidance before clinical use.
Scope and source
- Scope
- Adults presenting acutely with atrial fibrillation or atrial flutter in UK acute care.
- Jurisdiction
- UK
- Primary guidance
- NICE NG196: Atrial fibrillation: diagnosis and management
- Guidance last updated
- 2021-06-30
- Clinical reference reviewed
- 2026-09-08
- Review due
- 2027-03-08
Interactive clinical algorithm
This source-backed visual algorithm is available in the interactive page experience. Open the original guidance and the node notes before clinical use.
How to read this visual
- Read across the columns for the phases of the pathway; the swimlanes are who acts — Emergency team, Senior and cardiology care, Risk assessment and monitoring.
- Bold marks the dose, threshold or time limit that decides the next step; the rest of a label is context.
- Assess instability before selecting rate or rhythm management.
- Open notes for anticoagulation, pre-excitation and heart-failure limitations.
Clinical notes
- Use local medicines guidance and senior cardiology input for drug and electrical-cardioversion decisions.
- This does not replace RCUK peri-arrest tachyarrhythmia management for unstable rhythms.
Sources
- NICE NG196: Atrial fibrillation: diagnosis and management (NICE; 2021-06-30)
Open an editable reference copy
Create a personal educational copy. Verify the original guidance before clinical use.