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1. Longer and better lives for patients with atrial fibrillation: the 9th AFNET/EHRA consensus conference.

Author

Linz, Dominik, Andrade, Jason G, Arbelo, Elena, Boriani, Giuseppe, Breithardt, Guenter, Camm, A John, Caso, Valeria, Nielsen, Jens Cosedis, Melis, Mirko De, Potter, Tom De, Dichtl, Wolfgang, Diederichsen, Søren Zoega, Dobrev, Dobromir, Doll, Nicolas, Duncker, David, Dworatzek, Elke, Eckardt, Lars, Eisert, Christoph, Fabritz, Larissa, and Farkowski, Michal

Abstract

Aims Recent trial data demonstrate beneficial effects of active rhythm management in patients with atrial fibrillation (AF) and support the concept that a low arrhythmia burden is associated with a low risk of AF-related complications. The aim of this document is to summarize the key outcomes of the 9th AFNET/EHRA Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Methods and results Eighty-three international experts met in Münster for 2 days in September 2023. Key findings are as follows: (i) Active rhythm management should be part of the default initial treatment for all suitable patients with AF. (ii) Patients with device-detected AF have a low burden of AF and a low risk of stroke. Anticoagulation prevents some strokes and also increases major but non-lethal bleeding. (iii) More research is needed to improve stroke risk prediction in patients with AF, especially in those with a low AF burden. Biomolecules, genetics, and imaging can support this. (iv) The presence of AF should trigger systematic workup and comprehensive treatment of concomitant cardiovascular conditions. (v) Machine learning algorithms have been used to improve detection or likely development of AF. Cooperation between clinicians and data scientists is needed to leverage the potential of data science applications for patients with AF. Conclusions Patients with AF and a low arrhythmia burden have a lower risk of stroke and other cardiovascular events than those with a high arrhythmia burden. Combining active rhythm control, anticoagulation, rate control, and therapy of concomitant cardiovascular conditions can improve the lives of patients with AF. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Early diagnosis and better rhythm management to improve outcomes in patients with atrial fibrillation: the 8th AFNET/EHRA consensus conference.

Author

Schnabel, Renate B, Marinelli, Elena Andreassi, Arbelo, Elena, Boriani, Giuseppe, Boveda, Serge, Buckley, Claire M, Camm, A John, Casadei, Barbara, Chua, Winnie, Dagres, Nikolaos, Melis, Mirko de, Desteghe, Lien, Diederichsen, Søren Zöga, Duncker, David, Eckardt, Lars, Eisert, Christoph, Engler, Daniel, Fabritz, Larissa, Freedman, Ben, and Gillet, Ludovic

Abstract

Despite marked progress in the management of atrial fibrillation (AF), detecting AF remains difficult and AF-related complications cause unacceptable morbidity and mortality even on optimal current therapy. This document summarizes the key outcomes of the 8th AFNET/EHRA Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Eighty-three international experts met in Hamburg for 2 days in October 2021. Results of the interdisciplinary, hybrid discussions in breakout groups and the plenary based on recently published and unpublished observations are summarized in this consensus paper to support improved care for patients with AF by guiding prevention, individualized management, and research strategies. The main outcomes are (i) new evidence supports a simple, scalable, and pragmatic population-based AF screening pathway; (ii) rhythm management is evolving from therapy aimed at improving symptoms to an integrated domain in the prevention of AF-related outcomes, especially in patients with recently diagnosed AF; (iii) improved characterization of atrial cardiomyopathy may help to identify patients in need for therapy; (iv) standardized assessment of cognitive function in patients with AF could lead to improvement in patient outcomes; and (v) artificial intelligence (AI) can support all of the above aims, but requires advanced interdisciplinary knowledge and collaboration as well as a better medico-legal framework. Implementation of new evidence-based approaches to AF screening and rhythm management can improve outcomes in patients with AF. Additional benefits are possible with further efforts to identify and target atrial cardiomyopathy and cognitive impairment, which can be facilitated by AI. [ABSTRACT FROM AUTHOR]

Published
2023
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3. Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRA Consensus Conference.

Author

Fabritz, Larissa, Crijns, Harry J G M, Guasch, Eduard, Goette, Andreas, Häusler, Karl Georg, Kotecha, Dipak, Lewalter, Thorsten, Meyer, Christian, Potpara, Tatjana S, Rienstra, Michiel, Schnabel, Renate B, Willems, Stephan, Breithardt, Guenter, Camm, A John, Chan, Anthony, Chua, Winnie, Melis, Mirko de, Dimopoulou, Christina, Dobrev, Dobromir, and Easter, Christina

Subjects
STROKE prevention, STROKE diagnosis, ATRIAL fibrillation diagnosis, ATRIAL fibrillation treatment, CONSENSUS (Social sciences), STROKE, ATRIAL fibrillation, ANTICOAGULANTS, TREATMENT effectiveness, RISK assessment
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. [ABSTRACT FROM AUTHOR]

Published
2021
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4. Dynamic risk assessment to improve quality of care in patients with atrial fibrillation

Author

Ursula Ravens, Bushra S. Ilyas, Ulrich Schotten, Isabelle C. Van Gelder, Christian G Meyer, Burcu Vardar, Elena Andreassi Marinelli, Moritz F. Sinner, Stephan Willems, Christophe Leclercq, Renate B. Schnabel, Doreen Haase, Larissa Fabritz, Dierk Thomas, Dobromir Dobrev, Mattias Wieloch, Jeff S. Healey, Emma Svennberg, Paul D. Ziegler, Christina Easter, Stefan H. Hohnloser, Gregory Y.H. Lip, Gerhard Hindricks, A. John Camm, Andreas Goette, Monika Stoll, Irina Savelieva, Tatjana S. Potpara, Guenter Breithardt, Stéphane N. Hatem, Karl Georg Häusler, Rüdiger Smolnik, Alice J Sitch, Reza Wakili, Jan Steffel, Helmut Pürerfellner, Winnie Chua, José L. Merino, Anthony W.S. Chan, Harry J.G.M. Crijns, Thomas Huebner, Paulus Kirchhof, Christina Dimopoulou, Thorsten Lewalter, Stef Zeemering, Kenneth M. Stein, Mirko De Melis, Eduard Guasch, Jordi Heijman, Dipak Kotecha, Lluís Mont, Jonas Oldgren, Michael Nabauer, Michiel Rienstra, Ingo Kutschka, Aaron Isaacs, Lars Eckardt, Hein Heidbuchel, Cardiovascular Centre (CVC), University of Birmingham [Birmingham], University Hospitals Birmingham [Birmingham, Royaume-Uni], Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], University of Barcelona, University Hospital of Würzburg, University Hospital Hamburg-Eppendorf, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), University of Belgrade [Belgrade], University Medical Center Groningen [Groningen] (UMCG), Asklepios Klinik St. Georg, University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), University of London [London], Pfizer, Medtronic Inc [Minneapolis, MI, USA], European Society of Cardiology (ESC), University Hospital [Essen, Germany], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Population Health Research Institute [Hamilton, ON, Canada], Goethe-Universität Frankfurt am Main, University Hospital Göttingen, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Liverpool, La Paz University Hospital, Universitat de Barcelona (UB), University-Hospital Munich-Großhadern [München], Uppsala University, Ordensklinikum Linz Elisabethinen, St George's, University of London, Universität Zürich [Zürich] = University of Zurich (UZH), Boston Scientific, Karolinska Institutet [Stockholm], Heidelberg University Hospital [Heidelberg], University of Groningen [Groningen], University Hospital Essen, SANOFI Recherche, University of Antwerp (UA), Leipzig University, EHRA, 633196, EU Horizon 2020, AFNet, AFNET, MUMC+: MA Cardiologie (9), Cardiologie, RS: Carim - H01 Clinical atrial fibrillation, Fysiologie, RS: FHML MaCSBio, RS: Carim - B01 Blood proteins & engineering, Biochemie, RS: Carim - H08 Experimental atrial fibrillation, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)

Subjects
Technology, Quality management, Rate control, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Medizin, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, 030212 general & internal medicine, Stroke, Research priorities, CATHETER ABLATION, ROADMAP, Integrated care, Atrial fibrillation, 3. Good health, OPPORTUNITIES, Treatment Outcome, Consensus statement, Screening, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Rhythm control, Cognitive function, Cardiology and Cardiovascular Medicine, Risk assessment, medicine.medical_specialty, Consensus, Catheter ablation, Heart failure, Outcomes, DIAGNOSIS, Risk Assessment, CLASSIFICATION, 03 medical and health sciences, Big data, Anticoagulation, FUTURE, Physiology (medical), medicine, MANAGEMENT, Humans, Intensive care medicine, Atrial cardiomyopathy, business.industry, Research, Bleeding, Quality of care, Anticoagulants, EHRA, medicine.disease, Lifestyle, AFNET, Comorbidity, PREVENTION, REDUCTION, Human medicine, business
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.

Published
2021
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5. Early diagnosis and better rhythm management to improve outcomes in patients with atrial fibrillation: the 8th AFNET/EHRA consensus conference

Author

Renate B Schnabel, Elena Andreassi Marinelli, Elena Arbelo, Giuseppe Boriani, Serge Boveda, Claire M Buckley, A John Camm, Barbara Casadei, Winnie Chua, Nikolaos Dagres, Mirko de Melis, Lien Desteghe, Søren Zöga Diederichsen, David Duncker, Lars Eckardt, Christoph Eisert, Daniel Engler, Larissa Fabritz, Ben Freedman, Ludovic Gillet, Andreas Goette, Eduard Guasch, Jesper Hastrup Svendsen, Stéphane N Hatem, Karl Georg Haeusler, Jeff S Healey, Hein Heidbuchel, Gerhard Hindricks, F D Richard Hobbs, Thomas Hübner, Dipak Kotecha, Michael Krekler, Christophe Leclercq, Thorsten Lewalter, Honghuang Lin, Dominik Linz, Gregory Y H Lip, Maja Lisa Løchen, Wim Lucassen, Katarzyna Malaczynska-Rajpold, Steffen Massberg, Jose L Merino, Ralf Meyer, Lluıs Mont, Michael C Myers, Lis Neubeck, Teemu Niiranen, Michael Oeff, Jonas Oldgren, Tatjana S Potpara, George Psaroudakis, Helmut Pürerfellner, Ursula Ravens, Michiel Rienstra, Lena Rivard, Daniel Scherr, Ulrich Schotten, Dipen Shah, Moritz F Sinner, Rüdiger Smolnik, Gerhard Steinbeck, Daniel Steven, Emma Svennberg, Dierk Thomas, Mellanie True Hills, Isabelle C van Gelder, Burcu Vardar, Elena Palà, Reza Wakili, Karl Wegscheider, Mattias Wieloch, Stephan Willems, Henning Witt, André Ziegler, Matthias Daniel Zink, Paulus Kirchhof, General practice, ACS - Heart failure & arrhythmias, APH - Personalized Medicine, APH - Quality of Care, Schnabel, Renate B/0000-0001-7170-9509, Rienstra, Michiel/0000-0002-2581-070X, Pala, Elena/0000-0002-1074-990X, Schnabel, Renate B., Marinelli, Elena Andreassi, Arbelo, Elena, Boriani, Giuseppe, Boveda, Serge, Buckley, Claire M., Camm, A. John, Casadei, Barbara, Chua, Winnie, Dagres, Nikolaos, de Melis, Mirko, DESTEGHE, Lien, Diederichsen, Soren Zoga, Duncker, David, Eckardt, Lars, Eisert, Christoph, Engler, Daniel, Fabritz, Larissa, Freedman, Ben, Gillet, Ludovic, Goette, Andreas, Guasch, Eduard, Svendsen, Jesper Hastrup, Hatem, Stephane N., Haeusler, Karl Georg, Healey, Jeff S., HEIDBUCHEL, Hein, Hindricks, Gerhard, Hobbs, F. D. Richard, Huebner, Thomas, Kotecha, Dipak, Krekler, Michael, Leclercq, Christophe, Lewalter, Thorsten, Lin, Honghuang, Linz, Dominik, Lip, Gregory Y. H., Lochen, Maja Lisa, Lucassen, Wim, Malaczynska-Rajpold, Katarzyna, Massberg, Steffen, Merino, Jose L., Meyer , Ralf, Mont, Lluis, Myers, Michael C., Neubeck, Lis, Niiranen, Teemu, Oeff, Michael, Oldgren, Jonas, Potpara, Tatjana S., Psaroudakis, George, Purerfellner, Helmut, Ravens, Ursula, Rienstra, Michiel, Rivard, Lena, Scherr, Daniel, Schotten, Ulrich, Shah , Dipen, Sinner, Moritz F., Smolnik, Rudiger, Steinbeck, Gerhard, Steven, Daniel, Svennberg, Emma, Thomas, Dierk, Hills, Mellanie True, van Gelder, Isabelle C., Vardar, Burcu, Pala, Elena, Wakili, Reza, Wegscheider, Karl, Wieloch, Mattias, Willems , Stephan, Witt, Henning, Ziegler, Andre, Zink, Matthias Daniel, Kirchhof, Paulus, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: Carim - H08 Experimental atrial fibrillation

Subjects
Artificial intelligence, Technology, Consensus, Cost, Medizin, Heart failure, Outcomes, Guidelines, EHRA/HRS/APHRS/SOLAECE EXPERT CONSENSUS, Anticoagulation, Cognition, QUALITY-OF-LIFE, Physiology (medical), MAGNETIC-RESONANCE, Humans, PULMONARY VEIN ISOLATION, CARDIOVASCULAR EVENTS, Stroke/prevention & control, AFNET, Atrial cardiomyopathy, Atrial fibrillation, Bleeding, Catheter ablation, Cognitive function, Consensus statement, Dementia, EHRA, Integrated care, Quality of care, Research, Research priorities, Rhythm management, Screening, Stroke, ORAL ANTICOAGULANTS, CARDIOMYOPATHIES DEFINITION, RISK PREDICTION, Early Diagnosis, Human medicine, Cardiology and Cardiovascular Medicine, FOLLOW-UP, Atrial Fibrillation/complications
Abstract

Europace : the European journal of pacing, arrhythmias and cardiac electrophysiology euac062 (2022). doi:10.1093/europace/euac062, Published by Oxford Univ. Press, Oxford

Published
2022
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