International meeting focuses on screening, early and personalized treatment for atrial fibrillation

Reviewed by Emily Henderson, B.Sc.Oct 12 2021

Screening, early treatment, and personalized therapy for atrial fibrillation are on the agenda of an international meeting starting today.

The 8th joint consensus conference of the German Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA), a branch of the European Society of Cardiology (ESC), is being held from 12 to 14 October at the Dorint Hotel Hamburg-Eppendorf, Germany.

Atrial fibrillation is the most common heart rhythm disorder, affecting more than 40 million individuals globally. In many patients the condition is asymptomatic and the first manifestation is a debilitating stroke, heart failure, or a blackout. Early diagnosis, oral anticoagulation, and early rhythm control therapy are key concepts to prevent these complications. They will be discussed by over 60 international experts in atrial fibrillation in light of new data.

The meeting kicks off by asking "who should be screened for atrial fibrillation and how?". Potential screening strategies will be presented by members of AFFECT-EU, a large-scale EU funded project to detect atrial fibrillation and prevent subsequent strokes and death. Options include opportunistic screening at a single time point (e.g. at GP practices) using artificial intelligence or risk scores.

During the meeting, face-to-face discussions will fuel the development of scientific and practical ideas on the most effective way to screen for atrial fibrillation. Ongoing research will refine our methods for identifying the populations with the greatest need for screening and establish the role of different therapies (e.g. anticoagulation, rhythm control, treatment of concomitant cardiovascular conditions) in patients with atrial fibrillation that is detected through screening."

Professor Renate Schnabel, AFFECT-EU project coordinator

Also on the agenda: advances in phenotyping of patients with atrial fibrillation. Phenotyping is a way of describing subtypes of a condition according to a cluster of characteristics. These traits can include clinical signs and symptoms, electrocardiogram (ECG) results, imaging features detected by echocardiography, computed tomography or magnetic resonance tomography, and biomarker concentrations. Delegates will examine the latest discoveries in phenotyping - for example using artificial intelligence - with the ultimate aim of targeting current and novel therapies according to the subtype of atrial fibrillation (i.e. personalized medicine).

Plus: unsolved issues in atrial fibrillation treatment - including the changing role of rhythm control therapy in patients with atrial fibrillation. Since the last AFNET/EHRA consensus conference in 2019, the EAST-AFNET 4 trial reported that rhythm control therapy - with antiarrhythmic drugs or ablation - delivered soon after diagnosis of atrial fibrillation reduces cardiovascular complications without safety concerns.³ Several subanalyses of that trial support the effectiveness of early rhythm control therapy, while older trials and analyses of large electronic health record data bases confirm the safety of modern rhythm control therapy.

Professor Paulus Kirchhof, AFNET chair, said: "Based on these results and the safety of modern ablation and antiarrhythmic drug therapy, we expect participants to call for widespread implementation of early rhythm control therapy in all patients with recently diagnosed atrial fibrillation and an indication for oral anticoagulation. This paradigm shift towards the broad use of rhythm control therapy has the potential to reduce atrial fibrillation-related complications by 20%."

Professor Christophe Leclercq, EHRA president said: "This year's AFNET/EHRA consensus conference promises to showcase state-of-the-art findings in the diagnosis and treatment of atrial fibrillation. Through a combination of lectures, discussions, and break-out groups we will develop a consensus publication on early diagnosis and precision treatment of atrial fibrillation in the digital era."