Transforming atrial fibrillation management by targeting comorbidities and reducing atrial fibrillation burden: the 10th AFNET/EHRA consensus conference

Atrial fibrillation (AF) is a growing unmet medical need. To reduce its impact on patients' lives, improvements in stroke prevention therapy, treatment of concomitant conditions, and rhythm control therapy are actively developed: Innovations in anti-thrombotic agents, new anti-arrhythmic drugs (AADs), and novel interventional rhythm control therapies emerge alongside AF-reducing effects of general cardiometabolic therapies. Simple risk scores are slowly replaced by personalized AF risk estimation using quantifiable features. These developments were discussed by over 80 experts from academia and industry during the 10th Atrial Fibrillation NETwork /European Heart Rhythm Association consensus conference from 5 to 7 May 2025. The emerging consensus, described here, is multi-domain therapy combining stroke prevention, rhythm control, and therapy of concomitant cardiovascular conditions. This combines anti-coagulants, AADs, and AF ablation with old and new cardiometabolic drugs that can reduce AF risk, AF burden, and AF-related complications at scale. The paper furthermore describes quantitative traits that may enable a shift towards risk-driven therapy based on AF phenotypes. These can enable adjusted therapy strategies that are safe, accessible, and patient-centred. Applying modern data science and artificial intelligence methods to quantitative phenotypic and genetic features can further improve risk estimation and personalized therapy selection. At the same time, translational and clinical research into reversing the drivers of AF and into improved stroke prevention through new drugs and through combination therapies is needed. Together, these efforts offer pathways towards personalized, patient-centred, multi-modal, and accessible AF management that integrates rhythm control, stroke prevention, and therapy of concomitant conditions to bridge today's practical needs with tomorrow's therapeutic innovation.

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Publication Details

Journal
EP Europace
Published
2025-12-01
DOI
https://doi.org/10.1093/europace/euaf318
Primary Topic
Atrial Fibrillation Management and Outcomes
Type
article
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article

Transforming atrial fibrillation management by targeting comorbidities and reducing atrial fibrillation burden: the 10th AFNET/EHRA consensus conference

Stefan Simović, Stéphane Hatem, Wolfgang Dichtl, Tobias Toennis et al.
EP Europace
Atrial Fibrillation Management and Outcomes
article

Transforming atrial fibrillation management by targeting comorbidities and reducing atrial fibrillation burden: the 10th AFNET/EHRA consensus conference

Stefan Simović, Stéphane Hatem, Wolfgang Dichtl, Tobias Toennis, Stylianos E. Tzeis, Christian Sohns, Henning Witt, Jeff S. Healey, Søren Zöga Diederichsen, Daniel Steven, Götz Thomalla, Anders G. Holst, Janice Y. Chyou, Reza Wakili, Hein Heidbüchel, Andreas Rillig, Michał Orczykowski, Abdul Shokor Parwani, Guido Hack, Dobromir Dobrev, Moritz F. Sinner, Niels Voigt, Andreas Goette, Léna Rivard, Günter Breithardt, Gregory Y.H. Lip, Roderick H. van Leerdam, Steven A. Lubitz, Ulrich Schotten, Paulus Kirchhof, Tom J. R. De Potter, Philipp Sommer, Douglas S. Scherr, Larissa Fabritz, José Jalife, Mirko De Melis, Gerhard Steinbeck, Michiel Rienstra, Matteo Anselmino, Andreu Porta‐Sánchez, Elke Dworatzek, Dominik Linz, Claudio Gimpelewicz, Leif Hove‐Madsen, Ziad Hijazi, Wolfram Doehner, David Filgueiras‐Rama, Jason G. Andrade, José Luís Merino, Ursula Ravens, Mina K. Chung, Arian Sultan, Eric H. Boersma, Renate B. Schnabel, Elena Arbelo, Emma Svennberg, Ralf Meyer, Manish Wadhwa, Ariel Cohen, Giuseppe Boriani, Jan M. Nielsen
article en

Abstract

Atrial fibrillation (AF) is a growing unmet medical need. To reduce its impact on patients' lives, improvements in stroke prevention therapy, treatment of concomitant conditions, and rhythm control therapy are actively developed: Innovations in anti-thrombotic agents, new anti-arrhythmic drugs (AADs), and novel interventional rhythm control therapies emerge alongside AF-reducing effects of general cardiometabolic therapies. Simple risk scores are slowly replaced by personalized AF risk estimation using quantifiable features. These developments were discussed by over 80 experts from academia and industry during the 10th Atrial Fibrillation NETwork /European Heart Rhythm Association consensus conference from 5 to 7 May 2025. The emerging consensus, described here, is multi-domain therapy combining stroke prevention, rhythm control, and therapy of concomitant cardiovascular conditions. This combines anti-coagulants, AADs, and AF ablation with old and new cardiometabolic drugs that can reduce AF risk, AF burden, and AF-related complications at scale. The paper furthermore describes quantitative traits that may enable a shift towards risk-driven therapy based on AF phenotypes. These can enable adjusted therapy strategies that are safe, accessible, and patient-centred. Applying modern data science and artificial intelligence methods to quantitative phenotypic and genetic features can further improve risk estimation and personalized therapy selection. At the same time, translational and clinical research into reversing the drivers of AF and into improved stroke prevention through new drugs and through combination therapies is needed. Together, these efforts offer pathways towards personalized, patient-centred, multi-modal, and accessible AF management that integrates rhythm control, stroke prevention, and therapy of concomitant conditions to bridge today's practical needs with tomorrow's therapeutic innovation.

EP EuropaceVol. 27(12)
Délégation Paris 5 (FR), Goethe University Frankfurt (DE), University of Modena and Reggio Emilia (IT), Uppsala University (SE), University of Copenhagen (DK), Novartis (Switzerland) (CH), Birmingham City University (GB), Philips (Finland) (FI), University Medical Center Groningen (NL), Karolinska University Hospital (SE), Goethe-Institute United Kingdom (GB), University of Kragujevac (RS), Innsbruck Medical University (AT), Medical University of Białystok (PL), University of Liverpool (GB), University of Antwerp (BE), Inserm (FR), Bristol-Myers Squibb (Germany) (DE), Universität Hamburg (DE), Universitat de València (ES), University of Freiburg (DE), University of Groningen (NL), University of Cologne (DE), Baylor College of Medicine (US), Medical University of Graz (AT), Paderborn University (DE), Maastricht University Medical Centre (NL), Montreal Heart Institute (CA), Heart and Diabetes Center North Rhine-Westphalia (DE), Hospital Universitario La Paz (ES), University Medical Center Freiburg (DE), Hospital de Sant Pau (ES), Erasmus MC (NL), Aarhus University Hospital (DK), Bakken Museum (US), Copenhagen University Hospital (DK), Rigshospitalet (DK), Vancouver General Hospital (CA), Population Health Research Institute (CA), Spanish National Centre for Cardiovascular Research (ES), Karolinska Institutet (SE), Medtronic (Ireland) (IE), LMU Klinikum (DE), University College Birmingham (GB), University of Alabama at Birmingham (US), Maastricht University (NL), Cleveland Clinic Lerner College of Medicine (US), Sorbonne Université (FR), Liverpool Heart and Chest Hospital (GB), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Sorbonne Paris Cité (FR), Ambulatory Monitoring (United States) (US), Centro de Investigación en Red en Enfermedades Cardiovasculares (ES), Assistance Publique – Hôpitaux de Paris (FR), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (ES), Pfizer (Germany) (DE), Starnberg Hospital (DE), Onze Lieve Vrouwziekenhuis Hospital (BE), Mount Sinai Hospital (US), Antwerp University Hospital (BE), Hôpital Saint-Antoine (FR), Hospital La Paz Institute for Health Research (ES), University Hospital Münster (DE), Deutsches Herzzentrum der Charité (DE), University Medical Center Hamburg-Eppendorf (DE), Atrial Fibrillation NETwork (DE), Azienda Ospedaliero-Universitaria di Modena (IT), Department of Medical Sciences (RU), Centro de Investigación Biomédica en Red (ES), Universitätsmedizin Göttingen (DE), Asklepios Klinik St. Georg (DE), Philips (Netherlands) (NL), The Arrhythmia Institute (US), Institut d'Investigacions Biomèdiques de Barcelona (ES), German Centre for Cardiovascular Research (DE), Spanish National Centre for Cardiovascular Research (ES), Cardiovascular Research Center (BR), Mitera Hospital (GR), Brüderkrankenhaus St. Josef Paderborn (DE), Institute of Cardiology (PL), Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE), ERN GUARD-Heart (NL), Medtronic (Germany) (DE), University Hospital Cologne (DE), Fondation pour l’innovation en Cadiométabolisme et Nutrition (FR), Clinical Centre of Kragujevac (RS), Acesion Pharma (Denmark) (DK), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), West German Heart and Vascular Center Essen (DE), Institute of Pharmacology (CZ), Case Western Reserve University (US), Liverpool John Moores University (GB), Universidad Autónoma de Madrid (ES), Universitat de Barcelona (ES), University of Göttingen (DE), Charité - Universitätsmedizin Berlin (DE), University of Birmingham (GB), Ludwig-Maximilians-Universität München (DE), Aalborg University (DK), Ruhr University Bochum (DE), Icahn School of Medicine at Mount Sinai (US)
Abbott Laboratories, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, AtriCure, Boston Scientific Corporation, Deutsches Zentrum für Herz-Kreislaufforschung, Dutch Cardiovascular Alliance, Kompetenznetz Vorhofflimmern, Abiomed, National Institute for Health and Care Research, British Heart Foundation, European Commission, Deutsche Forschungsgemeinschaft, Fondation Leducq, ZonMw, Bundesministerium für Bildung und Forschung, Daiichi-Sankyo, Universität Hamburg, Deutsche Herzstiftung, University of California, Los Angeles, Novartis Pharma, HORIZON EUROPE Framework Programme, Medical Research Council, Biosense Webster
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Atrial Fibrillation Management and Outcomes
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