Persius/hicric huggingface dataset:
The Living Guidelines: Direct-current cardioversion of atrial fibrillation and atrial flutter: Polling Results for CLASS I Guidelines

# Class I Guidelines
1. When a rapid ventricular response does not respond promptly to pharmacological measures for patients with AF with ongoing myocardial ischemia, symptomatic hypotension, angina, or HF, immediate R-wave synchronized direct-current cardioversion is recommended. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 1 for Direct-current cardioversion of atrial fibrillation and atrial flutter should be:
2. Immediate direct-current cardioversion is recommended for patients with AF involving pre-excitation when very rapid tachycardia or hemodynamic instability occurs. (Level of Evidence: B) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 2 for Direct-current cardioversion of atrial fibrillation and atrial flutter should be:
3. Cardioversion is recommended in patients without hemodynamic instability when symptoms of AF are unacceptable to the patient. In case of early relapse of AF after cardioversion, repeated direct-current cardioversion attempts may be made following administration of antiarrhythmic medication. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 3 for Direct-current cardioversion of atrial fibrillation and atrial flutter should be:
Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update

# 2011 AHA/ACC Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease

## Smoking

## Blood pressure control

## Lipid management
Goal: Treatment with statin therapy; use statin therapy to achieve an LDL-C of <100 mg/dL; for very high risk- patients an LDL-C <70 mg/dL is reasonable; if triglycerides are 200 mg/dL, nonHDLC should be <130 mg/dL, whereas nonHDL-C <100 mg/dL for very high risk patients is reasonable

## Physical activity
Goal: At least 30 minutes, 7 days per week (minimum 5 days per week)

## Weight management
Goals: Body mass index: 18.5 to 24.9 kg/m2 Waist circumference: women <35 inches (<89 cm), men <40 inches (<102 cm)

## Type 2 diabetes mellitus management
Recommendations below are for prevention of cardiovascular complications.

## Antiplatelet agents/anticoagulants

## Renin-angiotensin-aldosterone system blockers

### ACE inhibitors

### ARBs

### Aldosterone blockade

## Beta blockers

## Influenza vaccination

## Depression

## Cardiac rehabilitation
JNC indicates the report of the National Heart, Lung, and Blood Institutes Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines; ACE, angiotensin-converting enzyme; ATP, Adult Treatment Panel; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; HbA1c, hemoglobin A1c; ACS, acute coronary syndrome; PCI, percutaneous coronary intervention; TIA, transient ischemic attack; INR, international normalized ratio; and ARB, angiotensin receptor blocker.*Presence of established CVD plus 1) multiple major risk factors (especially diabetes), 2) severe and poorly controlled risk factors (especially continued cigarette smoking), 3) multiple risk factors of the metabolic syndrome (especially high triglycerides 200 mg/dL plus nonHDL-C 30 mg/dL with low HDL-C <40 mg/dL), and 4) patients with ACSs.NonHDL-Ctotal cholesterol minus HDL-C.The use of bile acid sequestrants is relatively contraindicated when triglycerides are 200 mg/dL and is contraindicated when triglycerides are 500 mg/dL. Dietary supplement niacin must not be used as a substitute for prescription niacin.
The combination of high-dose statin plus fibrate (especially gemfibrozil) can increase risk for severe myopathy. Statin doses should be kept relatively low with
this combination.
Pregnant and lactating women should limit their intake of fish to minimize exposure to methylmercury. #Estimated creatinine clearance should be >30 mL/min.Potassium should be  <5.0 mEq/L.
The Living Guidelines: Pharmacological enhancement of direct-current cardioversion: Suggest Revisions to the CLASS IIa Guidelines

# Class IIa Guidelines
- Pretreatment with amiodarone, flecainide, ibutilide, propafenone, or sotalol can be useful to enhance the success of direct-current cardioversion and prevent recurrent atrial fibrillation. (Level of Evidence: B) 
- In patients who relapse to AF after successful cardioversion, it can be useful to repeat the procedure following prophylactic administration of antiarrhythmic medication. (Level of Evidence: C)
The Living Guidelines: Pharmacological enhancement of direct-current cardioversion: Suggest Revisions to the CLASS IIb Guidelines

# Class IIb Guidelines
- For patients with persistent AF, administration of beta blockers, disopyramide, diltiazem, dofetilide, procainamide, or verapamil may be considered, although the efficacy of these agents to enhance the success of direct-current cardioversion or to prevent early recurrence of AF is uncertain. (Level of Evidence: C) 
- Out-of-hospital initiation of antiarrhythmic medications may be considered in patients without heart disease to enhance the success of cardioversion of AF. (Level of Evidence: C) 
- Out-of-hospital administration of antiarrhythmic medications may be considered to enhance the success of cardioversion of AF in patients with certain forms of heart disease once the safety of the drug has been verified for the patient. (Level of Evidence: C)
The Living Guidelines: Pharmacological enhancement of direct-current cardioversion: Polling Results for CLASS IIa Guidelines

# Class IIa Guidelines
1. Pretreatment with amiodarone, flecainide, ibutilide, propafenone, or sotalol can be useful to enhance the success of direct-current cardioversion and prevent recurrent atrial fibrillation. (Level of Evidence: B) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 1 for pharmacological enhancement of direct-current cardioversion should be:
2. In patients who relapse to AF after successful cardioversion, it can be useful to repeat the procedure following prophylactic administration of antiarrhythmic medication. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 2 for pharmacological enhancement of direct-current cardioversion should be:
The Living Guidelines: Pharmacological enhancement of direct-current cardioversion: Polling Results for CLASS IIb Guidelines

# Class IIb Guidelines
1. For patients with persistent AF, administration of beta blockers, disopyramide, diltiazem, dofetilide, procainamide, or verapamil may be considered, although the efficacy of these agents to enhance the success of direct-current cardioversion or to prevent early recurrence of AF is uncertain. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIb Recommendation 1 for pharmacological enhancement of direct-current cardioversion should be:
2. Out-of-hospital initiation of antiarrhythmic medications may be considered in patients without heart disease to enhance the success of cardioversion of AF. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIb Recommendation 2 for pharmacological enhancement of direct-current cardioversion should be:
3. Out-of-hospital administration of antiarrhythmic medications may be considered to enhance the success of cardioversion of AF in patients with certain forms of heart disease once the safety of the drug has been verified for the patient. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIb Recommendation 3 for pharmacological enhancement of direct-current cardioversion should be:
The Living Guidelines: Pharmacological rate control during atrial fibrillation Suggest Revisions to the CLASS III Guidelines

# Class III Guidelines
- Digitalis should not be used as the sole agent to control the rate of ventricular response in patients with paroxysmal AF. (Level of Evidence: B) 
- Catheter ablation of the AV node should not be attempted without a prior trial of medication to control the ventricular rate in patients with AF. (Level of Evidence: C) 
- In patients with decompensated HF and AF, intravenous administration of a non dihydropyridine calcium channel antagonist may exacerbate hemodynamic compromise and is not recommended. (Level of Evidence: C) 
- Intravenous administration of digitalis glycosides or non dihydropyridine calcium channel antagonists to patients with AF and a pre-excitation syndrome may paradoxically accelerate the ventricular response and is not recommended. (Level of Evidence: C)
The Living Guidelines: Pharmacological rate control during atrial fibrillation Suggest Revisions to the CLASS IIa Guidelines

# Class IIa Guidelines
- A combination of digoxin and either a beta blocker or non dihydropyridine calcium channel antagonist is reasonable to control the heart rate both at rest and during exercise in patients with AF. The choice of medication should be individualized and the dose modulated to avoid bradycardia. (Level of Evidence: B) 
- It is reasonable to use ablation of the AV node or accessory pathway to control heart rate when pharmacological therapy is insufficient or associated with side effects. (Level of Evidence: B) 
- Intravenous amiodarone can be useful to control the heart rate in patients with AF when other measures are unsuccessful or contraindicated. (Level of Evidence: C) 
- When electrical cardioversion is not necessary in patients with AF and an accessory pathway, intravenous procainamide or ibutilide is a reasonable alternative. (Level of Evidence: C)
The Living Guidelines: Pharmacological rate control during atrial fibrillation Suggest Revisions to the CLASS IIb Guidelines

# Class IIb Guidelines
1. When the ventricular rate cannot be adequately controlled both at rest and during exercise in patients with AF using a ], non dihydropyridine calcium channel antagonist, or digoxin, alone or in combination, oral amiodarone may be administered to control the heart rate. (Level of Evidence: C) 
2. Intravenous procainamide, disopyramide, ibutilide, or amiodarone may be considered for hemodynamically stable patients with AF involving conduction over an accessory pathway. (Level of Evidence: B) 
3. When the rate cannot be controlled with pharmacological agents or tachycardia-mediated cardiomyopathy is suspected, catheter-directed ablation of the AV node may be considered in patients with AF to control the heart rate. (Level of Evidence: C)
Comparison Of Idraparinux With Vitamin K Antagonists For Prevention Of Thromboembolism In Patients With Atrial Fibrillation
About AMADEUS study
The  phase III AMADEUS study was a randomised, open label trial designed to  compare the efficacy and safety of once-a-week idraparinux versus oral VKA treatment for the long-term prevention of thromboembolic  events (stroke and non-central nervous system systemic embolism) in  patients with AF and at least one additional risk factor for stroke. The  predefined risk factors were previous ischemic stroke, transient ischemic attack or SE, hypertension  requiring drug treatment, left ventricular dysfunction, age >75  years, age between 65-75 years plus diabetes mellitus, or age between  65-75 years plus symptomatic coronary heart disease.
4,576 patients (2,283 in the idraparinux group and 2,293 in the VKA group) have been randomized between September 2003 and July 2005.
Patients  with AF who were eligible for VKA treatment were randomized to receive either subcutaneous idraparinux 2.5 mg once a week  or VKA therapy adjusted to achieve the target international normalized  ratio (INR) of 2.5 (range 2 to 3). The study was powered to show  non-inferior efficacy of idraparinux, compared with standard vitamin K antagonist (VKA) treatment  in patients with AF who require prolonged oral anticoagulation. The  primary efficacy endpoint was the composite of all strokes (ischemic,  hemorrhagic and undefined) and non-CNS SE within the planned treatment period. The principal safety endpoint  was the occurrence of major bleeding or clinically relevant non-major  bleeding. The other safety outcome was all cause mortality.
About BOREALIS-AF study
BOREALIS-AF  is a multicenter, randomized, double-blind, assessor-blind,  non-inferiority study comparing the efficacy and safety of once-a-week  subcutaneous biotinylated idraparinux with adjusted-dose warfarin in the prevention  of stroke and systemic thromboembolic events in patients with atrial  fibrillation.
Treatment  will be administrated for a period of 6 months to 2 years. All patients  will start with biotinylated idraparinux 3 mg (equivalent to base  idraparinux 2.5 mg) once-a-week for 7 weeks, and then the dose will be  reduced depending on age and renal function.
About idraparinux
Idraparinux  sodium is a novel long-acting synthetic highly potent synthetic and  specific indirect inhibitor of coagulation factor Xa, injectable  subcutaneously. Its long-duration of action makes it suitable for weekly administration.
The Living Guidelines: Pharmacological Cardioversion of Atrial Fibrillation: Suggest Revisions to the CLASS III Guidelines

# Class III Guidelines
- Digoxin and sotalol may be harmful when used for pharmacological cardioversion of AF and are not recommended. (Level of Evidence: A) 
- Quinidine, procainamide, disopyramide, and dofetilide should not be started out of hospital for conversion of AF to sinus rhythm. (Level of Evidence: B)
The Living Guidelines: Pharmacological Cardioversion of Atrial Fibrillation: Suggest Revisions to the CLASS IIa Guidelines

# Class IIa Guidelines
- Administration of amiodarone is a reasonable option for pharmacological cardioversion of AF. (Level of Evidence: A) 
- A single oral bolus dose of propafenone or flecainide (pill-in-the-pocket) can be administered to terminate persistent AF outside the hospital once treatment has proved safe in hospital for selected patients without sinus or AV node dysfunction, bundle branch block, QT-interval prolongation, the Brugada syndrome, or structural heart disease. Before antiarrhythmic medication is initiated, a beta blocker or non dihydropyridine calcium channel antagonist should be given to prevent rapid AV conduction in the event atrial flutter occurs. (Level of Evidence: C) 
- Administration of amiodarone can be beneficial on an outpatient basis in patients with paroxysmal or persistent AF when rapid restoration of sinus rhythm is not deemed necessary. (Level of Evidence: C)
The Living Guidelines: Pharmacological rate control during atrial fibrillation Suggest Revisions to the CLASS I Guidelines

# Class I Guidelines
- Measurement of the heart rate at rest and control of the rate using pharmacological agents (either a beta blocker or non dihydropyridine calcium channel antagonist, in most cases) are recommended for patients with persistent or permanent AF. (Level of Evidence: B) 
- In the absence of pre-excitation, intravenous administration of beta blockers (esmolol, metoprolol, or propranolol) or non dihydropyridine calcium channel antagonists (verapamil, diltiazem) is recommended to slow the ventricular response to AF in the acute setting, exercising caution in patients with hypotension or heart failure. (Level of Evidence: B) 
- Intravenous administration of digoxin or amiodarone is recommended to control the heart rate in patients with AF and heart failure who do not have an accessory pathway. (Level of Evidence: B) 
- In patients who experience symptoms related to AF during activity, the adequacy of heart rate control should be assessed during exercise, adjusting pharmacological treatment as necessary to keep the rate in the physiological range. (Level of Evidence: C) 
- Digoxin is effective following oral administration to control the heart rate at rest in patients with AF and is indicated for patients with heart failure, LV dysfunction, or for sedentary individuals. (Level of Evidence: C)
Recommendations for Perioperative ManagementTiming of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

# 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease

## Recommendations for Perioperative ManagementTiming of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT
-  Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA;  et al. (2016). "2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J Thorac Cardiovasc Surg. 152 (5): 12431275. doi:10.1016/j.jtcvs.2016.07.044. PMID 27751237.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link) .mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
Screening for atherosclerotic disease in other vascular beds in patient with lower extremity peripheral arterial disease

# 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease

# Recommendations for Screening for Atherosclerotic Disease in Other Vascular Beds for the Patient With PAD

## Recommendation for Abdominal Aortic Aneurysm(AAA):
The Living Guidelines: Pharmacological rate control during atrial fibrillation Polling Results for CLASS III Guidelines

# Class III Guidelines
1. Digitalis should not be used as the sole agent to control the rate of ventricular response in patients with paroxysmal AF. (Level of Evidence: B) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class III Recommendation 1 for pharmacological rate control during atrial fibrillation should be:
2. Catheter ablation of the AV node should not be attempted without a prior trial of medication to control the ventricular rate in patients with AF. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class III Recommendation 2 for pharmacological rate control during atrial fibrillation should be:
3. In patients with decompensated heart failure and AF, intravenous administration of a non dihydropyridine calcium channel antagonist may exacerbate hemodynamic compromise and is not recommended. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class III Recommendation 3 for pharmacological rate control during atrial fibrillation should be:
4. Intravenous administration of digitalis glycosides or non dihydropyridine calcium channel antagonists to patients with AF and a pre-excitation syndrome may paradoxically accelerate the ventricular response and is not recommended. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class III Recommendation 4 for pharmacological rate control during atrial fibrillation should be:
The Living Guidelines: Pharmacological rate control during atrial fibrillation Polling Results for CLASS IIa Guidelines

# Class IIa Guidelines
1. A combination of digoxin and either a beta blocker or non dihydropyridine calcium channel antagonist is reasonable to control the heart rate both at rest and during exercise in patients with AF. The choice of medication should be individualized and the dose modulated to avoid bradycardia. (Level of Evidence: B) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 1 for pharmacological rate control during atrial fibrillation should be:
2. It is reasonable to use ablation of the AV node or accessory pathway to control heart rate when pharmacological therapy is insufficient or associated with side effects. (Level of Evidence: B) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 2 for pharmacological rate control during atrial fibrillation should be:
3. Intravenous amiodarone can be useful to control the heart rate in patients with AF when other measures are unsuccessful or contraindicated. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 3 for pharmacological rate control during atrial fibrillation should be:
4. When electrical cardioversion is not necessary in patients with AF and an accessory pathway, intravenous procainamide or ibutilide is a reasonable alternative. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIa Recommendation 4 for pharmacological rate control during atrial fibrillation should be:
The Living Guidelines: Pharmacological rate control during atrial fibrillation Polling Results for CLASS IIb Guidelines

# Class IIb Guidelines
1. When the ventricular rate cannot be adequately controlled both at rest and during exercise in patients with AF using a ], non dihydropyridine calcium channel antagonist, or digoxin, alone or in combination, oral amiodarone may be administered to control the heart rate. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIb Recommendation 1 for pharmacological rate control during atrial fibrillation should be:
2. Intravenous procainamide, disopyramide, ibutilide, or amiodarone may be considered for hemodynamically stable patients with AF involving conduction over an accessory pathway. (Level of Evidence: B) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIb Recommendation 2 for pharmacological rate control during atrial fibrillation should be:
3. When the rate cannot be controlled with pharmacological agents or tachycardia-mediated cardiomyopathy is suspected, catheter-directed ablation of the AV node may be considered in patients with AF to control the heart rate. (Level of Evidence: C) 
ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class IIb Recommendation 3 for pharmacological rate control during atrial fibrillation should be: