TY - JOUR
T1 - Expert consensus document: Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment
AU - Fabritz, L.
AU - Guasch, E.
AU - Antoniades, C.
AU - Bardinet, I.
AU - Benninger, G.
AU - Betts, T.R.
AU - Brand, E.
AU - Breithardt, G.
AU - Bucklar-Suchankova, G.
AU - Camm, A.J.
AU - Cartlidge, D.
AU - Casadei, B.
AU - Chua, W.W.
AU - Crijns, Harry
AU - Deeks, J.
AU - Hatem, S.
AU - Hidden-Lucet, F.
AU - Kääb, S.
AU - Maniadakis, N.
AU - Martin, S.
AU - Mont, L.
AU - Reinecke, H.
AU - Sinner, M.F.
AU - Schotten, Ulrich
AU - Southwood, T.
AU - Stoll, Monika
AU - Vardas, P.
AU - Wakili, R.
AU - West, A.
AU - Ziegler, A.
AU - Kirchhof, P.
PY - 2016/4
Y1 - 2016/4
N2 - Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care.
AB - Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care.
KW - RANDOMIZED CLINICAL-TRIAL
KW - LEFT-VENTRICULAR DYSFUNCTION
KW - LATE GADOLINIUM ENHANCEMENT
KW - PULMONARY VEIN ISOLATION
KW - CHRONIC KIDNEY-DISEASE
KW - LONG-QT SYNDROME
KW - CONSENSUS CONFERENCE
KW - NERVE-STIMULATION
KW - EUROPEAN-SOCIETY
KW - RISK-FACTOR
U2 - 10.1038/nrcardio.2015.194
DO - 10.1038/nrcardio.2015.194
M3 - Article
C2 - 26701216
SN - 1759-5002
VL - 13
SP - 230
EP - 237
JO - Nature Reviews Cardiology
JF - Nature Reviews Cardiology
IS - 4
ER -