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

Larissa Fabritz; Harry J G M Crijns; Eduard Guasch; Andreas Goette; Karl Georg Häusler; Dipak Kotecha; Thorsten Lewalter; Christian Meyer; Tatjana S Potpara; Michiel Rienstra; Renate B Schnabel; Stephan Willems; Guenter Breithardt; A John Camm; Anthony Chan; Winnie Chua; Mirko de Melis; Christina Dimopoulou; Dobromir Dobrev; Christina Easter; 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 Y H Lip; Elena Andreassi Marinelli; Jose L Merino; Lluís Mont; Michael Nabauer; Jonas Oldgren; Helmut Pürerfellner; Ursula Ravens; Irina Savelieva; Moritz F Sinner; Alice Sitch; Rüdiger Smolnik; Jan Steffel; Kenneth Stein; Monika Stoll; Emma Svennberg; Dierk Thomas; Isabelle C Van Gelder; Burcu Vardar; Reza Wakili; Mattias Wieloch; Stef Zeemering; Paul D Ziegler; Hein Heidbuchel; Gerhard Hindricks; Ulrich Schotten; Paulus Kirchhof

doi:10.1093/europace/euaa279

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

Larissa Fabritz, Harry J G M Crijns, Eduard Guasch, Andreas Goette, Karl Georg Häusler, Dipak Kotecha, Thorsten Lewalter, Christian Meyer, Tatjana S Potpara, Michiel Rienstra, Renate B Schnabel, Stephan Willems, Guenter Breithardt, A John Camm, Anthony Chan, Winnie Chua, Mirko de Melis, Christina Dimopoulou, Dobromir Dobrev, Christina EasterLars 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 Y H Lip, Elena Andreassi Marinelli, Jose L Merino, Lluís Mont, Michael Nabauer, Jonas Oldgren, Helmut Pürerfellner, Ursula Ravens, Irina Savelieva, Moritz F Sinner, Alice Sitch, Rüdiger Smolnik, Jan Steffel, Kenneth Stein, Monika Stoll, Emma Svennberg, Dierk Thomas, Isabelle C Van Gelder, Burcu Vardar, Reza Wakili, Mattias Wieloch, Stef Zeemering, Paul D Ziegler, Hein Heidbuchel, Gerhard Hindricks, Ulrich Schotten, Paulus Kirchhof^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	329-344
Number of pages	16
Journal	EP Europace
Volume	23
Issue number	3
Early online date	12 Jan 2021
DOIs	https://doi.org/10.1093/europace/euaa279
Publication status	Published - Mar 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
CATHETER ABLATION
MANAGEMENT
CLASSIFICATION
OPPORTUNITIES
PREVENTION
REDUCTION
DIAGNOSIS
ROADMAP
STROKE
FUTURE

Access to Document

10.1093/europace/euaa279

Cite this

Fabritz, L., Crijns, H. J. G. M., Guasch, E., Goette, A., Häusler, K. G., Kotecha, D., Lewalter, T., Meyer, C., Potpara, T. S., Rienstra, M., Schnabel, R. B., Willems, S., Breithardt, G., Camm, A. J., Chan, A., Chua, W., de Melis, M., Dimopoulou, C., Dobrev, D., ... Kirchhof, P. (2021). Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRA Consensus Conference. EP Europace, 23(3), 329-344. https://doi.org/10.1093/europace/euaa279

@article{561238524b4447eb89b66d78a628ec86,

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

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.",

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, CATHETER ABLATION, MANAGEMENT, CLASSIFICATION, OPPORTUNITIES, PREVENTION, REDUCTION, DIAGNOSIS, ROADMAP, STROKE, FUTURE",

author = "Larissa Fabritz and Crijns, {Harry J G M} and Eduard Guasch and Andreas Goette and H{\"a}usler, {Karl Georg} and Dipak Kotecha and Thorsten Lewalter and Christian Meyer and Potpara, {Tatjana S} and Michiel Rienstra and Schnabel, {Renate B} and Stephan Willems and Guenter Breithardt and Camm, {A John} and Anthony Chan and Winnie Chua and {de Melis}, Mirko and Christina Dimopoulou and Dobromir Dobrev and Christina Easter and Lars Eckardt and Doreen Haase and Stephane Hatem and Healey, {Jeff S} and Jordi Heijman and Hohnloser, {Stefan H} and Thomas Huebner and Ilyas, {Bushra Saeed} and Aaron Isaacs and Ingo Kutschka and Christophe Leclercq and Lip, {Gregory Y H} and Marinelli, {Elena Andreassi} and Merino, {Jose L} and Llu{\'i}s Mont and Michael Nabauer and Jonas Oldgren and Helmut P{\"u}rerfellner and Ursula Ravens and Irina Savelieva and Sinner, {Moritz F} and Alice Sitch and R{\"u}diger Smolnik and Jan Steffel and Kenneth Stein and Monika Stoll and Emma Svennberg and Dierk Thomas and {Van Gelder}, {Isabelle C} and Burcu Vardar and Reza Wakili and Mattias Wieloch and Stef Zeemering and Ziegler, {Paul D} and Hein Heidbuchel and Gerhard Hindricks and Ulrich Schotten and Paulus Kirchhof",

year = "2021",

month = mar,

doi = "10.1093/europace/euaa279",

language = "English",

volume = "23",

pages = "329--344",

journal = "EP Europace",

issn = "1099-5129",

publisher = "Oxford University Press",

number = "3",

}

Fabritz, L, Crijns, HJGM, Guasch, E, Goette, A, Häusler, KG, Kotecha, D, Lewalter, T, Meyer, C, Potpara, TS, Rienstra, M, Schnabel, RB, Willems, S, Breithardt, G, Camm, AJ, Chan, A, Chua, W, de Melis, M, Dimopoulou, C, Dobrev, D, Easter, C, Eckardt, L, Haase, D, Hatem, S, Healey, JS, Heijman, J, Hohnloser, SH, Huebner, T, Ilyas, BS, Isaacs, A, Kutschka, I, Leclercq, C, Lip, GYH, Marinelli, EA, Merino, JL, Mont, L, Nabauer, M, Oldgren, J, Pürerfellner, H, Ravens, U, Savelieva, I, Sinner, MF, Sitch, A, Smolnik, R, Steffel, J, Stein, K, Stoll, M, Svennberg, E, Thomas, D, Van Gelder, IC, Vardar, B, Wakili, R, Wieloch, M, Zeemering, S, Ziegler, PD, Heidbuchel, H, Hindricks, G, Schotten, U & Kirchhof, P 2021, 'Dynamic risk assessment to improve quality of care in patients with atrial fibrillation: the 7th AFNET/EHRA Consensus Conference', EP Europace, vol. 23, no. 3, pp. 329-344. https://doi.org/10.1093/europace/euaa279

TY - JOUR

T1 - Dynamic risk assessment to improve quality of care in patients with atrial fibrillation

T2 - 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

PY - 2021/3

Y1 - 2021/3

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 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.

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 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.

KW - Atrial fibrillation

KW - Big data

KW - Lifestyle

KW - Heart failure

KW - Atrial cardiomyopathy

KW - Cognitive function

KW - Outcomes

KW - Quality of care

KW - Research

KW - Rate control

KW - Rhythm control

KW - Catheter ablation

KW - Anticoagulation

KW - Bleeding

KW - Research priorities

KW - Technology

KW - Stroke

KW - Integrated care

KW - Screening

KW - AFNET

KW - EHRA

KW - Consensus statement

KW - CATHETER ABLATION

KW - MANAGEMENT

KW - CLASSIFICATION

KW - OPPORTUNITIES

KW - PREVENTION

KW - REDUCTION

KW - DIAGNOSIS

KW - ROADMAP

KW - STROKE

KW - FUTURE

U2 - 10.1093/europace/euaa279

DO - 10.1093/europace/euaa279

M3 - Article

C2 - 33555020

SN - 1099-5129

VL - 23

SP - 329

EP - 344

JO - EP Europace

JF - EP Europace

IS - 3

ER -