Navigation Links
Atrial fibrillation: New management approaches for the 'new epidemic' in cardiovascular disease
Date:6/25/2011

Despite recent advances in the treatment of heart rhythm disturbances, mortality and morbidity rates associated withy atrial fibrillation (AF) remain "unacceptably high", according to a new report. The report, prepared jointly by the German Competence Network on Atrial Fibrillation (AFNET) and the European Heart Rhythm Association (EHRA), will be published at the EHRA EUROPACE 2011 congress in Madrid from 26-29 June. AF, says the report, is emerging as "the new epidemic" in cardiovascular disease.

According to the report, improvements in the management of AF can be achieved by several synergistic steps: the detection and better management of risk factors, good clinical use of new antithrombotic therapies, early detection of any new arrhythmia, and timely rhythm control treatment.

Identifying risk factors

The report lists the validated risk factors for AF as age, male gender, hypertension, valve disease, heart failure, diabetes, coronary artery disease and genetic factors. While age is one of the key risk factors for AF, genetic factors play a major role when AF occurs at young ages. Similarly, while male gender is strongly associated with "incident" AF, female gender is a risk factor for stroke in patients with established AF.

However, less validated and emerging risk factors have also been found in obesity, height (with relative risk rising markedly with 10 cm increments in height), sleep apnoea, excessive alcohol consumption, excessive endurance sports, smoking and chronic obstructive lung disease, and kidney disease.

The report recommends that analysis of several cardiac biomarkers - particularly natriuretic peptides - can help refine the assessment of AF risk. With genetic factors most closely associated with AF in the young, genetic biomarkers - indicative of genetically derived cardiomyopathies - may also help assess AF risk.

However, many of the determinants of AF risk remain "elusive", and the report highlights "a clear and unmet need to identify and characterize factors associated with progression of AF".

Stroke prevention

Stroke is the major risk of AF, with anticoagulants a potentially life-saving therapy. However, their administration comes with a risk of severe bleeding; the challenge is to balance the one with the other.

Vitamin K antagonists (such as warfarin), which reduce blood clotting, are traditional treatments, but their use is limited by food interactions, bleeding and monitoring. Newer anticoagulants, such as dabigatran, rivaroxaban, apixaban or edoxaban, may overcome some of these difficulties. They are highly effective in clinical trials, but their everyday use has not been tested. The report welcomes the introduction of these new therapies, but calls for more information about them, and for careful monitoring of their efficacy in clinical practice.

Early therapy for AF

However, even when anticoagulant therapy is optimally administered, AF patients still fare worse than patients with other cardiovascular conditions. Additional rate and rhythm control therapies, especially when administered early, may be preferred; such a "comprehensive" approach, concludes the report, may well help improve the outcome for AF patients.

While accepting that "continuous oral anticoagulation is the cornerstone of stroke preventing in AF patients", the report notes that "even on optimal anticoagulant therapy in controlled trials, the residual stroke rate in AF patients remains unacceptably high at approximately 1.5% per year".

Professor Paulus Kirchhof from the University Hospital Mnster in Germany and one of the organisers of Europace 2011 says: "The management of atrial fibrillation is undergoing remarkable changes - new antithrombotic drugs, catheter ablation and new insights into its mechanism. Our consensus report provides initial guidance in the good use of these new - and at times costly - therapeutic options."


'/>"/>

Contact: Jacqueline Partarrieu
press@escardio.org
33-492-947-756
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Women More Likely to Fail Treatment for Atrial Fibrillation
2. In Tests, Implanted Monitor Detects Atrial Fibrillation
3. Whistleblower Alerts Americans to Dangers of Risky Unapproved Treatment for Atrial Fibrillation
4. People with diabetes are at higher risk of atrial fibrillation
5. BioSTARTM device achieves 90 percent closure rate for atrial septal defect in children
6. Having Relative With Atrial Fibrillation Raises Own Risk
7. New trial studies link between stroke and atrial fibrillation
8. Heavy Drinking May Boost Risk for Atrial Fibrillation
9. Blood Pressure Drug Does Not Help Those With Atrial Fibrillation
10. Data evaluates rehospitalization and cost burden of AFib/atrial flutter
11. Cryoablation used to successfully treat atrial fibrillation at the Montreal Heart Institute
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/12/2017)... ... October 12, 2017 , ... Leading pediatric oncology experts at Children’s ... the 49th Congress of the International Society of Paediatric Oncology (SIOP) Oct. ... Center for Cancer and Blood Disorders at Children’s National, and Stephen P. Hunger, ...
(Date:10/12/2017)... ... October 12, 2017 , ... Women-owned and Grand Rapids-based ... and Brightest in Wellness® by Best and Brightest. OnSite Wellness will be honored ... 20 from 7:30 a.m. to 2 p.m. at the Henry Autograph Collection Hotel, ...
(Date:10/12/2017)... ... October 12, 2017 , ... In the United States, single-family ... some states—like New York, New Jersey, Massachusetts, Texas, Virginia, Connecticut, and California—the average ... extremely low property-tax rates, which contributes to the relatively lower cost of living ...
(Date:10/12/2017)... ... October 12, 2017 , ... Farm Forward joins ... other leading institutions in announcing the launch of the Leadership Circle , ... animals are raised for food. , Founding members of the Leadership Circle also ...
(Date:10/12/2017)... Texas (PRWEB) , ... October 12, 2017 , ... ... and biologics manufacturer, has expanded its executive staff with the addition of industry ... In this role, Slott will develop the national distribution and sales network, direct ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... 2017   Divoti USA will engrave and ... standard of the latest FDA requirements, which stipulates new criteria regarding ... in need of Medical ID jewelry such as Medical ID Bracelets, ... engraved in terms of the new FDA requirements . ... Divoti offers this dark mark fiber ...
(Date:10/11/2017)... FRISCO, Texas , Oct. 11, 2017 /PRNewswire/ ... healthcare services, has amplified its effort during National ... patients about hereditary cancer risks. ... Journal of Clinical Oncology calculated that more than ... to have inherited mutations in BRCA1 or BRCA2 and ...
(Date:10/7/2017)... --  Provista, a proven leader in the supply ... power, today announced a new resource area on Provistaco.com ... is the online home for case studies, articles on ... releases, slideshows and events. ... at their fingertips, viewers can also watch short videos ...
Breaking Medicine Technology: