Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRAConsensus 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 proplems 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.

Details

Original languageEnglish
JournalEP Europace
Early online date12 Jan 2021
Publication statusE-pub ahead of print - 12 Jan 2021

Keywords

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