Personalized management of atrial fibrillation: Proceedings from the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association consensus conference
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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.
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AF burden could modify the response to rhythm control therapy.
“There is some evidence suggesting that AF burden may influence stroke risk 44,124,164 and could modify the response to rhythm control therapy.76,165”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [76]
Disopyramide may be useful in vagally mediated atrial fibrillation.
“Disopyramide may be useful in 'vagally mediated' AF (e.g.AF occurring in athletes and/or during sleep 76 )”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [76]
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- Kappenberger L. A new look at atrial fibrillation: lessons learned from drugs, pacing, and ablation theapies-the Rene ´Laennec Lecture on Clinical Cardiology of the ESC 2012. Eur Heart J 2013; in press.
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Individualized approaches to thromboprophylaxis in atrial fibrillation
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Inflammatory proteomics profiling for prediction of incident atrial fibrillation
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Predictors of New Onset Atrial Fibrillation Burden in the Critically Ill
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Calcium Signaling Silencing in Atrial Fibrillation: Implications for Atrial Sodium Homeostasis
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Epstein Barr Virus and Atrial Fibrillation
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A Clinical Perspective on Atrial Fibrillation
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A new look at atrial fibrillation: lessons learned from drugs, pacing, and ablation therapies
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- Authors
- Kirchhof, P., Breithardt, G., Aliot, E., Al Khatib, S., Apostolakis, S., Auricchio, A., Bailleul, C., Bax, J., Benninger, G., Blomstrom-Lundqvist, C., Boersma, L., Boriani, G., Brandes, A., Brown, H., Brueckmann, M., Calkins, H., Casadei, B., Clemens, A., Crijns, H., Derwand, R., Dobrev, D., Ezekowitz, M., Fetsch, T., Gerth, A., Gillis, A., Gulizia, M., Hack, G., Haegeli, L., Hatem, S., Georg Hausler, K., Heidbuchel, H., Hernandez-Brichis, J., Jais, P., Kappenberger, L., Kautzner, J., Kim, S., Kuck, K.-H., Lane, D., Leute, A., Lewalter, T., Meyer, R., Mont, L., Moses, G., Mueller, M., Munzel, F., Nabauer, M., Nielsen, J. C., Oeff, M., Oto, A., Pieske, B., Pisters, R., Potpara, T., Rasmussen, L., Ravens, U., Reiffel, J., Richard-Lordereau, I., Schafer, H., Schotten, U., Stegink, W., Stein, K., Steinbeck, G., Szumowski, L., Tavazzi, L., Themistoclakis, S., Thomitzek, K., Van Gelder, I. C., von Stritzky, B., Vincent, A., Werring, D., Willems, S., Lip, G. Y. H., & Camm, A. J.
- Affiliations
- University Hospital Münster (DE)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- University of Birmingham (GB)
- Istituto Cardiocentro Ticino (CH)
- St. Jude Medical (United States) (US)
- Leiden University (NL)
- St. Antonius Ziekenhuis (NL)
- University of Bologna (IT)
- Odense University Hospital (DK)
- Boehringer Ingelheim (Germany) (DE)
- Johns Hopkins University (US)
- University of Oxford (GB)
- Maastricht University Medical Centre (NL)
- Daiichi Sankyo (Germany) (DE)
- University of Duisburg-Essen (DE)
- Lankenau Institute for Medical Research (US)
- Ludwig-Maximilians-Universität München (DE)
- University of Calgary (CA)
- Ospedale Garibaldi (IT)
- Bristol-Myers Squibb (Germany) (DE)
- University Hospital Zurich (CH)
- Sorbonne Université (FR)
- Universitair Ziekenhuis Leuven (BE)
- University of Lausanne (CH)
- Institute of Clinical and Experimental Medicine (CZ)
- Asklepios Klinik St. Georg (DE)
- TUM Klinikum (DE)
- Medtronic (Switzerland) (CH)
- Hospital Clínic de Barcelona (ES)
- Pfizer (Germany) (DE)
- Aarhus University Hospital (DK)
- Atrial Fibrillation NETwork (DE)
- Hacettepe University (TR)
- Medical University of Graz (AT)
- University of Belgrade (RS)
- Columbia University Irving Medical Center (US)
- Bayer (Germany) (DE)
- Boston Scientific (United States) (US)
- Starnberg Hospital (DE)
- University College Hospital (GB)
- Uppsala University (SE)
- ORCID
- Kirchhof, P.
- Auricchio, A.
- Bailleul, C.
- Bax, J.
- Boersma, L.
- Boriani, G.
- Brandes, A.
- Brueckmann, M.
- Calkins, H.
- Casadei, B.
- Clemens, A.
- Crijns, H.
- Dobrev, D.
- Gerth, A.
- Gillis, A.
- Gulizia, M.
- Hack, G.
- Haegeli, L.
- Hatem, S.
- Kautzner, J.
- Lane, D.
- Lewalter, T.
- Meyer, R.
- Mont, L.
- Nielsen, J. C.
- Pieske, B.
- Pisters, R.
- Potpara, T.
- Ravens, U.
- Reiffel, J.
- Schotten, U.
- Steinbeck, G.
- Tavazzi, L.
- Themistoclakis, S.
- Thomitzek, K.
- Werring, D.
- Lip, G. Y. H.
- Camm, A. J.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-08-27
- Volume
- 15
- Issue
- 11
- Pages
- 1540-1556
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2105963090
- Cited by
- 141
- References
- 227
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 11 · 2018: 8 · 2017: 18 · 2016: 20 · 2015: 26 · 2014: 29 · 2013: 2 · 2012: 1
- FWCI
- 17.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- University of Birmingham Research Portal (University of Birmingham) (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (090532)
- Kompetenznetz Vorhofflimmern
- British Heart Foundation (RG/11/15/29375)
- European Commission
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- atrial fibrillation, personalized medicine, risk stratification, direct oral anticoagulants, antiarrhythmic drugs, catheter ablation, rhythm control, atrial morphology, neuroimaging, genetic susceptibility, inflammation, stroke risk, heart failure
- MeSH terms
- Atrial Fibrillation, Brain, Echocardiography, Electrocardiography, Humans, Magnetic Resonance Imaging, Risk Factors, Biomarkers, Treatment Outcome, Disease Management, Precision Medicine
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