PDF(Pubmed)
Abstract：
OBJECTIVE: Recent trial data demonstrate beneficial effects of active rhythm management in patients with atrial fibrillation (AF) and support the concept that a low arrhythmia burden is associated with a low risk of AF-related complications. The aim of this document is to summarize the key outcomes of the 9th AFNET/EHRA Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA).
RESULTS: Eighty-three international experts met in Münster for 2 days in September 2023. Key findings are as follows: (i) Active rhythm management should be part of the default initial treatment for all suitable patients with AF. (ii) Patients with device-detected AF have a low burden of AF and a low risk of stroke. Anticoagulation prevents some strokes and also increases major but non-lethal bleeding. (iii) More research is needed to improve stroke risk prediction in patients with AF, especially in those with a low AF burden. Biomolecules, genetics, and imaging can support this. (iv) The presence of AF should trigger systematic workup and comprehensive treatment of concomitant cardiovascular conditions. (v) Machine learning algorithms have been used to improve detection or likely development of AF. Cooperation between clinicians and data scientists is needed to leverage the potential of data science applications for patients with AF.
CONCLUSIONS: Patients with AF and a low arrhythmia burden have a lower risk of stroke and other cardiovascular events than those with a high arrhythmia burden. Combining active rhythm control, anticoagulation, rate control, and therapy of concomitant cardiovascular conditions can improve the lives of patients with AF.
RESULTS: Eighty-three international experts met in Münster for 2 days in September 2023. Key findings are as follows: (i) Active rhythm management should be part of the default initial treatment for all suitable patients with AF. (ii) Patients with device-detected AF have a low burden of AF and a low risk of stroke. Anticoagulation prevents some strokes and also increases major but non-lethal bleeding. (iii) More research is needed to improve stroke risk prediction in patients with AF, especially in those with a low AF burden. Biomolecules, genetics, and imaging can support this. (iv) The presence of AF should trigger systematic workup and comprehensive treatment of concomitant cardiovascular conditions. (v) Machine learning algorithms have been used to improve detection or likely development of AF. Cooperation between clinicians and data scientists is needed to leverage the potential of data science applications for patients with AF.
CONCLUSIONS: Patients with AF and a low arrhythmia burden have a lower risk of stroke and other cardiovascular events than those with a high arrhythmia burden. Combining active rhythm control, anticoagulation, rate control, and therapy of concomitant cardiovascular conditions can improve the lives of patients with AF.
摘要：
目的：最近的试验数据证明了主动心律管理对心房颤动（AF）患者的有益作用，并支持低心律失常负担与低AF相关并发症风险相关的观点。本文件旨在总结心房颤动网络（AFNET）和欧洲心律协会（EHRA）第九届AFNET/EHRA共识会议的主要成果。
结果：2023年9月，83名国际专家在明斯特举行了为期2天的会议。主要发现如下：（i）对于所有合适的房颤患者，主动节律管理应该是默认初始治疗的一部分。(ii)具有设备检测到的AF的患者具有低的AF负担和低的中风风险。抗凝可以预防某些中风，并增加严重但非致死性出血。（iii）需要更多的研究来改善房颤患者的卒中风险预测，尤其是那些具有低AF负担。生物分子，遗传学,和成像可以支持这一点。(iv)AF的存在应引发伴随心血管疾病的系统检查和综合治疗。(V)机器学习算法已经用于改进AF的检测或可能的发展。临床医生和数据科学家之间的合作需要利用数据科学应用于房颤患者的潜力。
结论：与心律失常负担较高的患者相比，心律失常负担较低的房颤患者发生卒中和其他心血管事件的风险较低。结合主动节律控制，抗凝,速率控制,和伴随心血管疾病的治疗可以改善房颤患者的生活。
结果：2023年9月，83名国际专家在明斯特举行了为期2天的会议。主要发现如下：（i）对于所有合适的房颤患者，主动节律管理应该是默认初始治疗的一部分。(ii)具有设备检测到的AF的患者具有低的AF负担和低的中风风险。抗凝可以预防某些中风，并增加严重但非致死性出血。（iii）需要更多的研究来改善房颤患者的卒中风险预测，尤其是那些具有低AF负担。生物分子，遗传学,和成像可以支持这一点。(iv)AF的存在应引发伴随心血管疾病的系统检查和综合治疗。(V)机器学习算法已经用于改进AF的检测或可能的发展。临床医生和数据科学家之间的合作需要利用数据科学应用于房颤患者的潜力。
结论：与心律失常负担较高的患者相比，心律失常负担较低的房颤患者发生卒中和其他心血管事件的风险较低。结合主动节律控制，抗凝,速率控制,和伴随心血管疾病的治疗可以改善房颤患者的生活。
