World Heart Federation Roadmap on Atrial Fibrillation - A 2020 Update

被引：54

作者：

Freedman, Ben ^{[1
]}

Hindricks, Gerhard ^{[2
]}

Banerjee, Amitava ^{[3
]}

Baranchuk, Adrian ^{[4
]}

Ching, Chi Keong ^{[5
]}

Du, Xin ^{[6
]}

Fitzsimons, Donna ^{[7
]}

Healey, Jeff S. ^{[8
]}

Ikeda, Takanori ^{[9
]}

Lobban, Trudie C. A. ^{[10
]}

Mbakwem, Amam ^{[11
]}

Narasimhan, Calambur ^{[12
]}

Neubeck, Lis ^{[13
]}

Noseworthy, Peter ^{[14
]}

Philbin, Daniel M. ^{[15
]}

Pinto, Fausto J. ^{[16
]}

Rwebembera, Joselyn ^{[17
]}

Schnabel, Renate B. ^{[18
]}

Svendsen, Jesper Hastrup ^{[19
,20
]}

Aguinaga, Luis ^{[21
]}

Arbelo, Elena ^{[22
]}

Bohm, Michael ^{[23
]}

Farhan, Hasan Ali ^{[24
]}

Hobbs, F. D. Richard ^{[25
]}

Martinez-Rubio, Antoni ^{[26
]}

Militello, Claudio ^{[27
]}

Naik, Nitish ^{[28
]}

Noubiap, Jean Jacques ^{[29
]}

Perel, Pablo ^{[30
]}

Pineiro, Daniel Jose ^{[31
]}

Ribeiro, Antonio Luiz ^{[32
]}

Stepinska, Janina ^{[33
]}

机构：

[1] Univ Sydney, Heart Res Inst, Sydney, NSW, Australia

[2] Leipzig Heart Inst, Leipzig, Germany

[3] UCL, London, England

[4] Queens Univ, Kingston, CA USA

[5] Natl Heart Ctr Singapore, Singapore, Singapore

[6] Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China

[7] Queens Univ Belfast, Belfast, Antrim, North Ireland

[8] McMaster Univ, Hamilton, ON, Canada

[9] Toho Univ, Fac Med, Tokyo, Japan

[10] Arrhythmia Alliance & Atrial Fibrillat Assoc, Stratford Upon Avon, England

[11] Lagos Univ Teaching Hosp, Lagos, Nigeria

[12] AIG Hosp, Gachibowli, Telangana, India

[13] Edinburgh Napier Univ, Edinburgh, Midlothian, Scotland

[14] Mayo Clin, Rochester, MN USA

[15] Brown Univ, Providence, RI 02912 USA

[16] Santa Maria Univ Hosp CHULN, CCUL, CAML, Lisbon, Portugal

[17] Uganda Heart Inst, Kampala, Uganda

[18] Univ Heart & Vasc Ctr Hamburg, Hamburg, Germany

[19] Copenhagen Univ Hsopital, Rigshosp, Copenhagen, Denmark

[20] Univ Copenhagen, Copenhagen, Denmark

[21] Ctr Integral Arritmias Tucuman, San Miguel De Tucuman, Argentina

[22] Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain

[23] Univ Klinikum Saarlandes, Homburg, Germany

[24] Baghdad Heart Ctr, Baghdad, Iraq

[25] Univ Oxford, Oxford, England

[26] Univ Autonoma Barcelona, Univ Hosp Sabadell, Barcelona, Spain

[27] Sanatorio Sagrad Corazon, OSECAC, Buenos Aires, DF, Argentina

[28] All India Inst Med Sci, New Delhi, India

[29] Univ Adelaide, Adelaide, SA, Australia

[30] World Heart Federat, Geneva, Switzerland

[31] Univ Buenos Aires, Buenos Aires, DF, Argentina

[32] Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil

[33] Natl Inst Cardiol, Warsaw, Poland

来源：

GLOBAL HEART | 2021年 / 16卷 / 01期

基金：

英国医学研究理事会;

关键词：

atrial fibrillation; AF; cardiology; WHF; NOACs; digital technology; DIRECT ORAL ANTICOAGULANTS; CARDIOVASCULAR RISK-FACTORS; CARDIOLOGY WORKING GROUP; TERM-FOLLOW-UP; LONG-TERM; CARDIAC-ARRHYTHMIAS; APPENDAGE OCCLUSION; ESSENTIAL MEDICINES; CATHETER ABLATION; GLOBAL BURDEN;

D O I：

10.5334/gh.1023

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world's population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them. Since publication of the AF Roadmap in 2017, there have been many technological advances including devices and artificial intelligence for identification and prediction of unknown AF, better methods to achieve rhythm control, and widespread uptake of smartphones and apps that could facilitate new approaches to healthcare delivery and increasing community AF awareness. In addition, the World Health Organisation added the non-vitamin K antagonist oral anticoagulants (NOACs) to the Essential Medicines List, making it possible to increase advocacy for their widespread adoption as therapy to prevent stroke. These advances motivated the WHF to commission a 2020 AF Roadmap update. Three years after the original Roadmap publication, the identified barriers and solutions were judged still relevant, and progress has been slow. This 2020 Roadmap update reviews the significant changes since 2017 and identifies priority areas for achieving the goals of reducing death and disability related to AF, particularly targeted at low-middle income countries. These include advocacy to increase appreciation of the scope of the problem; plugging gaps in guideline management and prevention through physician education, increasing patient health literacy, and novel ways to increase access to integrated healthcare including mHealth and digital transformations; and greater emphasis on achieving practical solutions to national and regional entrenched barriers. Despite the advances reviewed in this update, the task will not be easy, but the health rewards of implementing solutions that are both innovative and practical will be great.

引用

页数：36

共 256 条

[21] Obesity is associated with incident atrial fibrillation independent of gender: A meta-analysis [J].