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lication of the NICE guidelines. 8 Their study suggests that only 84% of 131 patients with diagnosis of AF had either electrocardiogram (ECG) documentation in primary and/or secondary care. Almost half of the patients with AF were managed in primary care alone and the diagnosis of AF was generally accurate. The use of echocardiography is an important part of management, and in the paper by Loo et al only 44% of the study population underwent an echocardiogram. 8 However, this percentage increases in those who were diagnosed with AF after 2000 and those who had cardiology input from secondary care. This could probably be explained by a better understanding of the management of AF, better educational efforts and, perhaps, a better provision of echocardiography services from secondary care. The overall rate of anticoagulation was higher than other studies, but there remains a discrepancy, with only about half of

Can the NICE guidelines on the management of atrial fibrillation improve its management?