Personalized management of atrial fibrillation: Proceedings from the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association consensus conference
Open Access
- 27 August 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in EP Europace
- Vol. 15 (11), 1540-1556
- https://doi.org/10.1093/europace/eut232
Abstract
The management of atrial fibrillation (AF) has seen marked changes in past years, with the introduction of new oral anticoagulants, new antiarrhythmic drugs, and the emergence of catheter ablation as a common intervention for rhythm control. Furthermore, new technologies enhance our ability to detect AF. Most clinical management decisions in AF patients can be based on validated parameters that encompass type of presentation, clinical factors, electrocardiogram analysis, and cardiac imaging. Despite these advances, patients with AF are still at increased risk for death, stroke, heart failure, and hospitalizations. During the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association (AFNET/EHRA) consensus conference, we identified the following opportunities to personalize management of AF in a better manner with a view to improve outcomes by integrating atrial morphology and damage, brain imaging, information on genetic predisposition, systemic or local inflammation, and markers for cardiac strain. Each of these promising avenues requires validation in the context of existing risk factors in patients. More importantly, a new taxonomy of AF may be needed based on the pathophysiological type of AF to allow personalized management of AF to come to full fruition. Continued translational research efforts are needed to personalize management of this prevalent disease in a better manner. All the efforts are expected to improve the management of patients with AF based on personalized therapy.Keywords
This publication has 197 references indexed in Scilit:
- Meta-analysis identifies six new susceptibility loci for atrial fibrillationNature Genetics, 2012
- A Common β1-Adrenergic Receptor Polymorphism Predicts Favorable Response to Rate-Control Therapy in Atrial FibrillationJournal of the American College of Cardiology, 2012
- COL4A1 mutations in patients with sporadic late‐onset intracerebral hemorrhageAnnals of Neurology, 2011
- Risk of Death and Cardiovascular Events in Initially Healthy Women With New-Onset Atrial FibrillationJAMA, 2011
- Usefulness of Single Nucleotide Polymorphism in Chromosome 4q25 to Predict In-Hospital and Long-Term Development of Atrial Fibrillation and Survival in Patients Undergoing Coronary Artery Bypass GraftingThe American Journal of Cardiology, 2011
- Echocardiographic left atrial reverse remodeling after catheter ablation of atrial fibrillation is predicted by preablation delayed enhancement of left atrium by magnetic resonance imagingAmerican Heart Journal, 2010
- Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI: Implications for disease progression and response to catheter ablationHeart Rhythm, 2010
- Long-term Outcomes in Individuals With Prolonged PR Interval or First-Degree Atrioventricular BlockJAMA, 2009
- Cerebral microbleeds: a guide to detection and interpretationThe Lancet Neurology, 2009
- Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort studyThe Lancet, 2009