Research Priorities in the Secondary Prevention of Atrial Fibrillation: A National Heart, Lung, and Blood Institute Virtual Workshop Report

被引：34

作者：

Benjamin, Emelia J. ^{[1
,2
]}

Al-Khatib, Sana M. ^{[3
,4
]}

Desvigne-Nickens, Patrice ^{[5
]}

Alonso, Alvaro ^{[6
]}

Djousse, Luc ^{[7
,8
]}

Forman, Daniel E. ^{[9
]}

Gillis, Anne M. ^{[10
]}

Hendriks, Jeroen M. L. ^{[11
,12
,13
]}

Hills, Mellanie True ^{[14
]}

Kirchhof, Paulus ^{[15
,16
,17
,18
]}

Link, Mark S. ^{[19
]}

Marcus, Gregory M. ^{[20
]}

Mehra, Reena ^{[21
,22
]}

Murray, Katherine T. ^{[23
]}

Parkash, Ratika ^{[24
]}

Pina, Ileana L. ^{[25
,26
,27
]}

Redline, Susan ^{[28
]}

Rienstra, Michiel ^{[29
]}

Sanders, Prashanthan ^{[11
,12
]}

Somers, Virend K. ^{[30
]}

Van Wagoner, David R. ^{[31
]}

Wang, Paul J. ^{[32
]}

Cooper, Lawton S. ^{[5
]}

Go, Alan S. ^{[33
,34
,35
,36
]}

机构：

[1] Boston Univ, Sch Med, Dept Med, Cardiovasc Med, Boston, MA 02118 USA

[2] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[3] Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA

[4] Duke Univ, Med Ctr, Duke Clin, Res Inst, Durham, NC USA

[5] NHLBI, Div Cardiovasc Sci, Natl Inst Hlth, Bldg 10, Bethesda, MD 20892 USA

[6] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA

[7] Brigham & Womens Hosp, Dept Med, Div Aging, 75 Francis St, Boston, MA 02115 USA

[8] Harvard Med Sch, Boston, MA 02115 USA

[9] Univ Pittsburgh, Med Ctr, VA Pittsburgh Hlthcare Syst, Inst Aging,Div Geriatr & Cardiol, Pittsburgh, PA USA

[10] Univ Calgary, Libin Cardiovasc Inst Alberta, Calgary, AB, Canada

[11] Univ Adelaide, Ctr Heart Rhythm Disorders, Adelaide, SA, Australia

[12] Royal Adelaide Hosp, Adelaide, SA, Australia

[13] Flinders Univ S Australia, Coll Nursing & Hlth Sci, Caring Futures Inst, Adelaide, SA, Australia

[14] Amer Fdn Womens Hlth, StopAfib Org, Decatur, TX USA

[15] Univ Heart & Vasc, Ctr UKE Hamburg, Dept Cardiol, Hamburg, Germany

[16] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England

[17] German Ctr Cardiovasc Res, Partner Site Hamburg Kiel Lubeck, Berlin, Germany

[18] AFNET, Munster, Germany

[19] Univ Texas Southwestern Med Ctr Dallas, Div Cardiol, Dept Med, Dallas, TX 75390 USA

[20] Univ Calif San Francisco, Div Cardiol, San Francisco, CA 94143 USA

[21] Cleveland Clin, Lerner Res Inst, Inst Heart & Vasc, Resp Inst,Neurol Inst,Sleep Disorders Ctr, Cleveland, OH 44106 USA

[22] Cleveland Clin, Mol Cardiol Dept, Cleveland, OH 44106 USA

[23] Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA

[24] Dalhousie Univ, QEII Hlth Sci Center, Div Cardiol, Halifax, NS, Canada

[25] Wayne State Univ, Detroit, MI USA

[26] Cent Michigan Univ, Mt Pleasant, MI 48859 USA

[27] US FDA, OPEQ, Ctr Devices & Radiol Hlth, Silver Spring, MD USA

[28] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA

[29] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands

[30] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA

[31] Cleveland Clin, Lerner Coll Med, Cleveland, OH 44106 USA

[32] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA

[33] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA

[34] Kaiser Permanente Bernard J Tyson Sch Med, Dept Hlth Syst Sci, Pasadena, CA USA

[35] Univ Calif San Francisco, Dept Epidemiol Biostat & Med, San Francisco, CA 94143 USA

[36] Stanford Univ, Dept Med Hlth Res & Policy, Stanford, CA 94305 USA

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2021年 / 10卷 / 16期

基金：

美国国家卫生研究院; 英国医学研究理事会;

关键词：

atrial fibrillation; cardiac rehabilitation; prevention; research; risk factors; sleep; OBSTRUCTIVE SLEEP-APNEA; RISK-FACTOR; CARDIAC REHABILITATION; CATHETER ABLATION; REDUCES RISK; USUAL CARE; SHORT-TERM; EXERCISE; OBESITY; RECURRENCE;

D O I：

10.1161/JAHA.121.021566

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

There has been sustained focus on the secondary prevention of coronary heart disease and heart failure; yet, apart from stroke prevention, the evidence base for the secondary prevention of atrial fibrillation (AF) recurrence, AF progression, and AF-related complications is modest. Although there are multiple observational studies, there are few large, robust, randomized trials providing definitive effective approaches for the secondary prevention of AF. Given the increasing incidence and prevalence of AF nationally and internationally, the AF field needs transformative research and a commitment to evidenced-based secondary prevention strategies. We report on a National Heart, Lung, and Blood Institute virtual workshop directed at identifying knowledge gaps and research opportunities in the secondary prevention of AF. Once AF has been detected, lifestyle changes and novel models of care delivery may contribute to the prevention of AF recurrence, AF progression, and AF-related complications. Although benefits seen in small subgroups, cohort studies, and selected randomized trials are impressive, the widespread effectiveness of AF secondary prevention strategies remains unknown, calling for development of scalable interventions suitable for diverse populations and for identification of subpopulations who may particularly benefit from intensive management. We identified critical research questions for 6 topics relevant to the secondary prevention of AF: (1) weight loss; (2) alcohol intake, smoking cessation, and diet; (3) cardiac rehabilitation; (4) approaches to sleep disorders; (5) integrated, team-based care; and (6) nonanticoagulant pharmacotherapy. Our goal is to stimulate innovative research that will accelerate the generation of the evidence to effectively pursue the secondary prevention of AF.

引用

页数：33

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