Personalized management of atrial fibrillation: Proceedings from the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association consensus conference

Paulus Kirchhof, Günter Breithardt, Etienne Aliot, Sana Al Khatib, Stavros Apostolakis, Angelo Auricchio, Christophe Bailleul, Jeroen Bax, Gerlinde Benninger, Carina Blomstrom-Lundqvist, Lucas Boersma, Giuseppe Boriani, Axel Brandes, Helen Brown, Martina Brueckmann, Hugh Calkins, Barbara Casadei, Andreas Clemens, Harry Crijns, Roland Derwand, Dobromir Dobrev, Michael Ezekowitz, Thomas Fetsch, Andrea Gerth, Anne Gillis, Michele Gulizia, Guido Hack, Laurent Haegeli, Stephane Hatem, Karl Georg Häusler, Hein Heidbüchel, Jessica Hernandez-Brichis, Pierre Jais, Lukas Kappenberger, Joseph Kautzner, Steven Kim, Karl-Heinz Kuck, Deirdre Lane, Angelika Leute, Thorsten Lewalter, Ralf Meyer, Lluis Mont, Gregory Moses, Markus Mueller, Felix Münzel, Michael Näbauer, Jens Cosedis Nielsen, Michael Oeff, Ali Oto, Burkert Pieske, Ron Pisters, Tatjana Potpara, Lars Rasmussen, Ursula Ravens, James Reiffel, Isabelle Richard-Lordereau, Herbert Schäfer, Ulrich Schotten, Wim Stegink, Kenneth Stein, Gerhard Steinbeck, Lukasz Szumowski, Luigi Tavazzi, Sakis Themistoclakis, Karen Thomitzek, Isabelle C Van Gelder, Berndt von Stritzky, Alphons Vincent, David Werring, Stephan Willems, Gregory Y H Lip, A John Camm
Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology 2013, 15 (11): 1540-56
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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