Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRA Consensus Conference

Research output: Contribution to journalArticlepeer-review

Authors

  • Harry J G M Crijns
  • Eduard Guasch
  • Andreas Goette
  • Karl Hausler
  • Thorsten Lewalter
  • Christian G Meyer
  • Tatjana S. Potpara
  • Michiel Rienstra
  • Renate B Schnabel
  • Stephan Willems
  • Guenter Breithardt
  • A John Camm
  • Anthony Chan
  • Mirko De Melis
  • Christina Dimopoulou
  • Dobromir Dobrev
  • Lars Eckardt
  • Doreen Haase
  • Stephane Hatem
  • Jeff S. Healey
  • Jordi Heijman
  • Stefan H Hohnloser
  • Thomas Huebner
  • Bushra Saeed Ilyas
  • Aaron Isaacs
  • Ingo Kutschka
  • Christophe Leclercq
  • Gregory YH Lip
  • Elena Andreassi Marinelli
  • Jose L Merino
  • Lluis Mont
  • Michael Nabauer
  • Jonas Oldgren
  • Helmut Pürerfellner
  • Ursula Ravens
  • Irina Savelieva
  • Moritz F Sinner
  • Rudiger Smolnik
  • Jan Steffel
  • Kenneth Stein
  • Monika Stoll
  • Emma Svennberg
  • Dierk Thomas
  • Isabelle C Van Gelder
  • Burcu Vardar
  • Reza Wakili
  • Mattias Wieloch
  • Stef Zeemering
  • Paul Ziegler
  • Hein Heidbuchel
  • Gerhard Hindricks
  • Ulrich Schotten
  • Paulus Kirchhof

Colleges, School and Institutes

Abstract

AIMS: The risk of developing atrial fibrillation (AF) and its complications continues to increase, despite good progress in preventing AF-related strokes. METHODS AND RESULTS: This article summarizes the outcomes of the 7th Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA) held in Lisbon in March 2019. Sixty-five international AF specialists met to present new data and find consensus on pressing issues in AF prevention, management and future research to improve care for patients with AF and prevent AF-related complications. This article is the main outcome of an interactive, iterative discussion between breakout specialist groups and the meeting plenary. AF patients have dynamic risk profiles requiring repeated assessment and risk-based therapy stratification to optimize quality of care. Interrogation of deeply phenotyped datasets with outcomes will lead to a better understanding of the cardiac and systemic effects of AF, interacting with comorbidities and predisposing factors, enabling stratified therapy. New proposals include an algorithm for the acute management of patients with AF and heart failure, a call for a refined, data-driven assessment of stroke risk, suggestions for anticoagulation use in special populations, and a call for rhythm control therapy selection based on risk of AF recurrence. CONCLUSION: The remaining morbidity and mortality in patients with AF needs better characterization. Likely drivers of the remaining AF-related problems are AF burden, potentially treatable by rhythm control therapy, and concomitant conditions, potentially treatable by treating these conditions. Identifying the drivers of AF-related complications holds promise for stratified therapy.

Bibliographic note

Publisher Copyright: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. Funding Information: The 7th AFNET/EHRA Consensus Conference was co-financed by AFNET and EHRA, and received additional financial support from the CATCH ME consortium (EU Horizon 2020 grant number 633196). Industry participants paid an attendance fee for the conference and provided an industry perspective during the discussions at the meeting but had no involvement in the writing process. Publisher Copyright: © 2020 Published on behalf of the European Society of Cardiology. All rights reserved.

Details

Original languageEnglish
Pages (from-to)329–344
Number of pages16
JournalEP Europace
Volume23
Issue number3
Early online date29 Dec 2020
Publication statusPublished - Mar 2021

Keywords

  • AFNET, Anticoagulation, Atrial cardiomyopathy, Atrial fibrillation, Big data, Bleeding, Catheter ablation, Cognitive function, Consensus statement, EHRA, Heart failure, Integrated care, Lifestyle, Outcomes, Quality of care, Rate control, Research, Research priorities, Rhythm control, Screening, Stroke, Technology