Personalized Atrial Fibrillation Management Is Imperative

Personalized management is the only way to close the mortality gap for patients with atrial fibrillation (AF), according to a new consensus paper.

The Atrial Fibrillation competence NETwork (AFNET) and the European Heart Rhythm Association (EHRA), two branches of the European Society of Cardiology (ESC; Sophia Antipolis, France) have released a consensus paper, which identifies three main ways to better characterize the underlying cause of AF in order to improve treatment. These include an electrocardiogram (ECG); imaging, especially echocardiography and magnetic resonance imaging (MRI); and biomarkers (proteins or genes measured in blood to identify the type of AF).

The consensus paper also proposes a new taxonomy of AF, based on its pathophysiology, since the current classification is imperfect due to overlaps between categories, with the majority of AF patients falling into the “unclassified” AF group. The paper calls for a better understanding of why AF develops in an individual patient before it can be classified based on biomarkers, imaging, or ECG, in addition to the clinical parameters, and thus would aid in the development of better therapies. The consensus paper was presented at the ESC annual congress, held during August 2013 in Amsterdam (The Netherlands).

"We are in an intermediate position with AF; with the introduction of oral anticoagulant therapy we can prevent about two-thirds of all strokes in AF,” said consensus paper presenter Prof. Paulus Kirchhof, MD, of the University of Birmingham (United Kingdom). “But patients with AF still have a higher mortality compared to their age and cardiovascular risk matched peers without AF, and we are not able to reduce that mortality by much, even when we apply all the evidence based therapies.”

“Every fourth patient with AF is admitted to hospital at least once a year due to AF, which illustrates the high morbidity and healthcare costs associated with the disease,” added Prof. Kirchhof. “This is the first European consensus document on personalized management of AF, which is the most promising way to further improve morbidity and mortality in AF patients.”

Related Links:
European Society of Cardiology
University of Birmingham