Redefining the Standard for Atrial Fibrillation: A Patient-centric Report

Overview

Journal Eur Cardiol

Specialty Cardiology & Vascular Diseases

Date 2021 Apr 16

PMID 33859732

Authors

Carina Blomstrom Lundqvist

Helmut Purerfellner

Alex White

Richard Schilling

Affiliations

Soon will be listed here.

Abstract

A roundtable discussion with three European clinical experts in AF and one expert patient diagnosed and treated for AF was conducted in London in October 2019. The panel discussed the implications of AF for patients, current patient pathways, what treatment outcomes were relevant for patients and how the recommendations for the management of AF may change in the future, based on the outcomes of recently published and on-going clinical trials. This article summarises the discussion, and draws upon wider sources to detail best practice and optimal patient treatment pathways.

References

Kirchhof P . The future of atrial fibrillation management: integrated care and stratified therapy. Lancet. 2017; 390(10105):1873-1887. DOI: 10.1016/S0140-6736(17)31072-3. View

Perez M, Mahaffey K, Hedlin H, Rumsfeld J, Garcia A, Ferris T . Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation. N Engl J Med. 2019; 381(20):1909-1917. PMC: 8112605. DOI: 10.1056/NEJMoa1901183. View

Asad Z, Yousif A, Khan M, Al-Khatib S, Stavrakis S . Catheter Ablation Versus Medical Therapy for Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Circ Arrhythm Electrophysiol. 2019; 12(9):e007414. DOI: 10.1161/CIRCEP.119.007414. View

Friberg L, Tabrizi F, Englund A . Catheter ablation for atrial fibrillation is associated with lower incidence of stroke and death: data from Swedish health registries. Eur Heart J. 2016; 37(31):2478-87. DOI: 10.1093/eurheartj/ehw087. View

Aliot E, Brandes A, Eckardt L, Elvan A, Gulizia M, Heidbuchel H . The EAST study: redefining the role of rhythmcontrol therapy in atrial fibrillation: EAST, the Early treatment of Atrial fibrillation for Stroke prevention Trial. Eur Heart J. 2015; 36(5):255-6. DOI: 10.1093/eurheartj/ehu476. View

Lane D, Aguinaga L, Blomstrom-Lundqvist C, Boriani G, Dan G, Hills M . Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad.... Europace. 2015; 17(12):1747-69. DOI: 10.1093/europace/euv233. View

McCabe P . What patients want and need to know about atrial fibrillation. J Multidiscip Healthc. 2011; 4:413-9. PMC: 3215351. DOI: 10.2147/JMDH.S19315. View

Takigawa M, Takahashi A, Kuwahara T, Okubo K, Takahashi Y, Watari Y . Long-term follow-up after catheter ablation of paroxysmal atrial fibrillation: the incidence of recurrence and progression of atrial fibrillation. Circ Arrhythm Electrophysiol. 2014; 7(2):267-73. DOI: 10.1161/CIRCEP.113.000471. View

Pappone C, Vicedomini G, Santinelli V . Atrio-Esophageal Fistula After AF Ablation: Pathophysiology, Prevention &Treatment. J Atr Fibrillation. 2017; 6(3):860. PMC: 5153030. DOI: 10.4022/jafib.860. View

10.

Konig S, Ueberham L, Schuler E, Wiedemann M, Reithmann C, Seyfarth M . In-hospital mortality of patients with atrial arrhythmias: insights from the German-wide Helios hospital network of 161 502 patients and 34 025 arrhythmia-related procedures. Eur Heart J. 2018; 39(44):3947-3957. DOI: 10.1093/eurheartj/ehy528. View

11.

Pappone C, Augello G, Sala S, Gugliotta F, Vicedomini G, Gulletta S . A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study. J Am Coll Cardiol. 2006; 48(11):2340-7. DOI: 10.1016/j.jacc.2006.08.037. View

12.

Packer D, Mark D, Robb R, Monahan K, Bahnson T, Poole J . Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA. 2019; 321(13):1261-1274. PMC: 6450284. DOI: 10.1001/jama.2019.0693. View

13.

Forleo G, Mantica M, De Luca L, Leo R, Santini L, Panigada S . Catheter ablation of atrial fibrillation in patients with diabetes mellitus type 2: results from a randomized study comparing pulmonary vein isolation versus antiarrhythmic drug therapy. J Cardiovasc Electrophysiol. 2008; 20(1):22-8. DOI: 10.1111/j.1540-8167.2008.01275.x. View

14.

Pokorney S, Kim S, Thomas L, Fonarow G, Kowey P, Gersh B . Cardioversion and subsequent quality of life and natural history of atrial fibrillation. Am Heart J. 2017; 185:59-66. DOI: 10.1016/j.ahj.2016.10.018. View

15.

Bunch T, May H, Bair T, Johnson D, Weiss J, Crandall B . Increasing time between first diagnosis of atrial fibrillation and catheter ablation adversely affects long-term outcomes. Heart Rhythm. 2013; 10(9):1257-62. DOI: 10.1016/j.hrthm.2013.05.013. View

16.

Magnussen C, Niiranen T, Ojeda F, Gianfagna F, Blankenberg S, Njolstad I . Sex Differences and Similarities in Atrial Fibrillation Epidemiology, Risk Factors, and Mortality in Community Cohorts: Results From the BiomarCaRE Consortium (Biomarker for Cardiovascular Risk Assessment in Europe). Circulation. 2017; 136(17):1588-1597. PMC: 5657474. DOI: 10.1161/CIRCULATIONAHA.117.028981. View

17.

Wilber D, Pappone C, Neuzil P, de Paola A, Marchlinski F, Natale A . Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010; 303(4):333-40. DOI: 10.1001/jama.2009.2029. View

18.

Odutayo A, Wong C, Hsiao A, Hopewell S, Altman D, Emdin C . Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ. 2016; 354:i4482. DOI: 10.1136/bmj.i4482. View

19.

Andersson T, Magnuson A, Bryngelsson I, Frobert O, Henriksson K, Edvardsson N . All-cause mortality in 272,186 patients hospitalized with incident atrial fibrillation 1995-2008: a Swedish nationwide long-term case-control study. Eur Heart J. 2013; 34(14):1061-7. PMC: 3618889. DOI: 10.1093/eurheartj/ehs469. View

20.

Jais P, Cauchemez B, Macle L, Daoud E, Khairy P, Subbiah R . Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation. 2008; 118(24):2498-505. DOI: 10.1161/CIRCULATIONAHA.108.772582. View