title: Early and comprehensive management of atrial fibrillation: executive summary of the proceedings from the 2nd AFNET-EHRA consensus conference 'research perspectives in AF'.
abstract: Atrial fibrillation (AF) causes important mortality and morbidity on a population-level. So far, we do not have the means to prevent AF or AF-related complications adequately. Therefore, over 70 experts on atrial fibrillation convened for the 2nd AFNET/EHRA consensus conference to suggest directions for research to improve management of AF patients (Appendix 1). The group defined three main areas in need for research in AF: 1. better understanding of the mechanisms of AF; 2. Improving rhythm control monitoring and management; and 3. comprehensive cardiovascular risk management in AF patients. The group put forward the hypothesis that successful therapy of AF and its associated complications will require comprehensive therapy. This applies e.g. to the "old" debate of "rate versus rhythm control", since rhythm control is generally added to underlying (continued) rate control therapy, but also to the emerging debate of "antiarrhythmic drugs versus catheter ablation", of which both may be needed in most patients to maintain sinus rhythm, but also to therapy of conditions that predispose to AF and contribute to cardiovascular complications such as stroke, cognitive decline, heart failure, and acute coronary syndromes. We call for research initiatives aiming at a better understanding of the different causes of AF and its complications, and at development and validation of mechanism-based therapies. The future of AF therapy may require a combination of management of underlying and concomitant conditions, early and comprehensive rhythm control therapy, adequate control of ventricular rate and cardiac function, and continuous therapy to prevent AF-associated complications (e.g. antithrombotic therapy). The reasons for these suggestions are detailed in this paper.
authors.affiliation: Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Strasse 33, D-48149 Münster, Germany. kirchhp@uni-muenster.de
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
authors.forename: Jeroen
authors.initials: J
authors.lastname: Bax
authors.forename: Carina
authors.initials: C
authors.lastname: Blomstrom-Lundquist
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.forename: A John
authors.initials: AJ
authors.lastname: Camm
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cappato
authors.forename: Francisco
authors.initials: F
authors.lastname: Cosio
authors.forename: Harry
authors.initials: H
authors.lastname: Crijns
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Diener
authors.forename: Andreas
authors.initials: A
authors.lastname: Goette
authors.forename: Carsten W
authors.initials: CW
authors.lastname: Israel
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Stanley
authors.initials: S
authors.lastname: Nattel
authors.forename: Richard L
authors.initials: RL
authors.lastname: Page
authors.forename: Ursula
authors.initials: U
authors.lastname: Ravens
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schotten
authors.forename: Gerhard
authors.initials: G
authors.lastname: Steinbeck
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
authors.forename: Albert
authors.initials: A
authors.lastname: Waldo
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
authors.forename: Günter
authors.initials: G
authors.lastname: Breithardt
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D010349:Patient Compliance; D012307:Risk Factors; D012308:Risk Management; D020521:Stroke / Q000517:prevention & control
chemical_list: D000889:Anti-Arrhythmia Agents; D005343:Fibrinolytic Agents