Longer and better lives for patients with atrial fibrillation: the 9th AFNET/EHRA consensus conference
Por:
Linz, D, Andrade, JG, Arbelo, E, Boriani, G, Breithardt, G, Camm, AJ, Caso, V, Nielsen, JC, De Melis, M, De Potter, T, Dichtl, W, Diederichsen, SZ, Dobrev, D, Doll, N, Duncker, D, Dworatzek, E, Eckardt, L, Eisert, C, Fabritz, L, Farkowski, M, Filgueiras-Rama, D, Goette, A, Guasch, E, Hack, G, Hatem, S, Haeusler, KG, Healey, JS, Heidbuechel, H, Hijazi, Z, Hofmeister, LH, Hove-Madsen, L, Huebner, T, Kääb, S, Kotecha, D, Malaczynska-Rajpold, K, Merino, JL, Metzner, A, Mont, L, Ng, GA, Oeff, M, Parwani, AS, Puererfellner, H, Ravens, U, Rienstra, M, Sanders, P, Scherr, D, Schnabel, R, Schotten, U, Sohns, C, Steinbeck, G, Steven, D, Toennis, T, Tzeis, S, van Gelder, IC, van Leerdam, RH, Vernooy, K, Wadhwa, M, Wakili, R, Willems, S, Witt, H, Zeemering, S, Kirchhof, P
Publicada:
1 abr 2024
Ahead of Print:
1 abr 2024
Resumen:
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 Munster 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.
Graphical Abstract
Filiaciones:
Linz, D:
Maastricht Univ, Med Ctr, Cardiovasc Res Inst Maastricht, Dept Cardiol, Maastricht, Netherlands
Univ Copenhagen, Fac Hlth & Med Sci, Dept Biomed Sci, Copenhagen, Denmark
Andrade, JG:
Vancouver Gen Hosp, Div Cardiol, Vancouver, BC, Canada
Montreal Heart Inst, Montreal, PQ, Canada
Arbelo, E:
Univ Barcelona, Hosp Clin, Inst Clin Cardiovasc, Barcelona, Spain
Inst Invest Biomed August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
European Reference Network Rare Low Prevalence & C, I-40138 Bologna, Italy
Boriani, G:
Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Cardiol Div, Polyclin Modena, Modena, Italy
Breithardt, G:
Univ Hosp Muenster, Dept Cardiovasc Med, Munster, Germany
Atrial Fibrillat Network AFNET, Munster, Germany
Camm, AJ:
St Georges Univ London, Cardiol Clin Acad Grp, Mol & Clin Sci Inst, London, England
Caso, V:
Univ Perugia, Santa Maria della Misericordia Hosp, Stroke Unit, I-06100 Perugia, Italy
Nielsen, JC:
Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark
Aarhus Univ, Dept Clin Med, Aarhus, Denmark
De Melis, M:
Bakken Res Ctr, Maastricht, Netherlands
De Potter, T:
Onze Lieve Vrouw Hosp, Cardiovasc Ctr, Aalst, Belgium
Dichtl, W:
Med Univ Innsbruck, Dept Internal Med Cardiol & Angiol 3, Innsbruck, Austria
Diederichsen, SZ:
Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Copenhagen, Denmark
Dobrev, D:
Univ Duisburg Essen, Univ Hosp Essen, Inst Pharmacol, Fac Med, Essen, Germany
Doll, N:
Schuchtermann Klin, Dept Cardiac Surg, Bad Rothenfelde, Germany
Duncker, D:
Hannover Med Sch, Hannover Heart Rhythm Ctr, Dept Cardiol & Angiol, Hannover, Germany
Dworatzek, E:
Pfizer Pharm GmbH, Berlin, Germany
Eckardt, L:
Atrial Fibrillat Network AFNET, Munster, Germany
Univ Hosp Munster, Dept Cardiol Electrophysiol 2, Munster, Germany
Eisert, C:
Preventicus GmbH, Jena, Germany
Fabritz, L:
Atrial Fibrillat Network AFNET, Munster, Germany
UKE, Univ Ctr Cardiovasc Sci, UHZ, Hamburg, Germany
German Ctr Cardiovasc Res DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany
Univ Birmingham, Inst Cardiovasc Sci, Birmingham, England
Farkowski, M:
Minist Interior & Adm, Dept Cardiol, Natl Med Inst, Warsaw, Poland
Filgueiras-Rama, D:
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Ctr Nacl Invest Cardiovasc CNIC, Novel Arrhythmogen Mech Program, Madrid, Spain
Hosp Univ Clin San Carlos IdISSC, Inst Invest Sanitaria, Cardiovasc Inst, C Prof Martin Lagos, Madrid, Spain
Goette, A:
Atrial Fibrillat Network AFNET, Munster, Germany
St Vincenz Hosp Paderborn, Dept Cardiol & Intens Care Med, Paderborn, Germany
Guasch, E:
Inst Invest Biomed August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Univ Barcelona, Clin Barcelona, Barcelona, Spain
Hack, G:
Bristol Myers Squibb GmbH & Co KGaA, Munich, Germany
Hatem, S:
Hosp Pitie Salpetriere, IHU ICAN, Paris, France
Haeusler, KG:
Atrial Fibrillat Network AFNET, Munster, Germany
Univ Klinikum Wurzburg UKW, Dept Neurol, Wurzburg, Germany
Healey, JS:
McMaster Univ, Div Cardiol, Hamilton, ON, Canada
Populat Hlth Res Inst, Hamilton, ON, Canada
Heidbuechel, H:
Univ Antwerp, Antwerp Univ Hosp, Cardiovasc Sci, Antwerp, Belgium
Hijazi, Z:
Univ Antwerp, Antwerp Univ Hosp, Cardiovasc Sci, Antwerp, Belgium
Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden
Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden
Hofmeister, LH:
Global Med Affairs Bayer AG, Berlin, Germany
Hove-Madsen, L:
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE, Madrid, Spain
Biomed Res Inst Barcelona IIBB CSIC, Barcelona, Spain
Hosp Santa Creu & Sant Pau, IR St Pau, Barcelona, Spain
Kääb, S:
European Reference Network Rare Low Prevalence & C, I-40138 Bologna, Italy
Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Med 1, Munich, Germany
German Ctr Cardiovasc Res DZHK, Partner Site Munich, Munich Heart Alliance, Munich, Germany
Kotecha, D:
Univ Hosp Birmingham NHS Trust, NIHR Birmingham Biomed Res Ctr, Birmingham, England
Malaczynska-Rajpold, K:
East & North Hertfordshire NHS Trust, Lister Hosp, Stevenage, Herts, England
Guys & St Thomas NHS Fdn Trust, Royal Brompton Hosp, London, England
Merino, JL:
Autonomous Univ Madrid, La Paz Univ Hosp, IdiPaz, Madrid, Spain
Metzner, A:
Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany
Ng, GA:
Univ Leicester, Dept Cardiovasc Sci, Leicester, England
NIHR Leicester Biomed Res Ctr, Leicester, England
Oeff, M:
Atrial Fibrillat Network AFNET, Munster, Germany
Med Hsch Brandenburg, Cardiol Dept, Brandenburg Havel, Germany
Parwani, AS:
Deutsch Herzzentrum Charite CVK, Dept Cardiol, Berlin, Germany
Puererfellner, H:
Ordensklinikum Linz Elisabethinen, Cardiol Dept, Linz, Austria
Ravens, U:
Atrial Fibrillat Network AFNET, Munster, Germany
Univ Clin Freiburg, Inst Expt Cardiovasc Med, Freiburg, Germany
Rienstra, M:
Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands
Sanders, P:
Univ Adelaide, Ctr Heart Rhythm Disorders, Adelaide, SA, Australia
Royal Adelaide Hosp, Adelaide, Australia
Scherr, D:
Med Univ Graz, Div Cardiol, Graz, Austria
Schnabel, R:
Atrial Fibrillat Network AFNET, Munster, Germany
Schotten, U:
Atrial Fibrillat Network AFNET, Munster, Germany
Maastricht Univ, Cardiovasc Res Inst Maastricht, Dept Physiol, Maastricht, Netherlands
Sohns, C:
Ruhr Univ Bochum, Klin Elektrophysiol Rhythmol, Herz & Diabet Zentrum, Nordrhein Westfalen Univ Klin, Bad Oeynhausen, Germany
Steinbeck, G:
Atrial Fibrillat Network AFNET, Munster, Germany
Clin Starnberg, Ctr Cardiol, Starnberg, Germany
Steven, D:
Atrial Fibrillat Network AFNET, Munster, Germany
Univ Hosp Cologne, Heart Ctr, Dept Electrophysiol, Cologne, Germany
Toennis, T:
German Ctr Cardiovasc Res DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany
Tzeis, S:
Mitera Hosp, Cardiol Dept, Athens, Greece
van Gelder, IC:
Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands
van Leerdam, RH:
Royal Philips, Amsterdam, Netherlands
Wadhwa, M:
Philips Ambulatory Monitoring & Diagnost, Med Off, San Diego, CA USA
Wakili, R:
Atrial Fibrillat Network AFNET, Munster, Germany
German Ctr Cardiovasc Res DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany
Goethe Univ, Dept Med & Cardiol, Frankfurt, Germany
Willems, S:
Atrial Fibrillat Network AFNET, Munster, Germany
German Ctr Cardiovasc Res DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany
German Ctr Cardiovasc Res DZHK, Partner Site Rhine Main, Berlin, Germany
Witt, H:
Pfizer Pharm GmbH, Berlin, Germany
Kirchhof, P:
Atrial Fibrillat Network AFNET, Munster, Germany
German Ctr Cardiovasc Res DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany
Univ Birmingham, Inst Cardiovasc Sci, Birmingham, England
Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany
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