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

TY - JOUR

T1 - Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRA Consensus Conference

AU - Fabritz, Larissa

AU - Crijns, Harry J G M

AU - Guasch, Eduard

AU - Goette, Andreas

AU - Häusler, Karl Georg

AU - Kotecha, Dipak

AU - Lewalter, Thorsten

AU - Meyer, Christian

AU - Potpara, Tatjana S

AU - Rienstra, Michiel

AU - Schnabel, Renate B

AU - Willems, Stephan

AU - Breithardt, Guenter

AU - Camm, A John

AU - Chan, Anthony

AU - Chua, Winnie

AU - de Melis, Mirko

AU - Dimopoulou, Christina

AU - Dobrev, Dobromir

AU - Easter, Christina

AU - Eckardt, Lars

AU - Haase, Doreen

AU - Hatem, Stephane

AU - Healey, Jeff S

AU - Heijman, Jordi

AU - Hohnloser, Stefan H

AU - Huebner, Thomas

AU - Ilyas, Bushra Saeed

AU - Isaacs, Aaron

AU - Kutschka, Ingo

AU - Leclercq, Christophe

AU - Lip, Gregory Y H

AU - Marinelli, Elena Andreassi

AU - Merino, Jose L

AU - Mont, Lluís

AU - Nabauer, Michael

AU - Oldgren, Jonas

AU - Pürerfellner, Helmut

AU - Ravens, Ursula

AU - Savelieva, Irina

AU - Sinner, Moritz F

AU - Sitch, Alice

AU - Smolnik, Rüdiger

AU - Steffel, Jan

AU - Stein, Kenneth

AU - Stoll, Monika

AU - Svennberg, Emma

AU - Thomas, Dierk

AU - Van Gelder, Isabelle C

AU - Vardar, Burcu

AU - Wakili, Reza

AU - Wieloch, Mattias

AU - Zeemering, Stef

AU - Ziegler, Paul D

AU - Heidbuchel, Hein

AU - Hindricks, Gerhard

AU - Schotten, Ulrich

AU - Kirchhof, Paulus

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

PY - 2021/3/8

Y1 - 2021/3/8

N2 - 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.

AB - 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.

KW - Anticoagulants/adverse effects

KW - Atrial Fibrillation/diagnosis

KW - Consensus

KW - Humans

KW - Risk Assessment

KW - Risk Factors

KW - Stroke/diagnosis

KW - Treatment Outcome

U2 - 10.1093/europace/euaa279

DO - 10.1093/europace/euaa279

M3 - SCORING: Journal article

C2 - 33555020

VL - 23

SP - 329

EP - 344

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 3

ER -