Research Priorities in Atrial Fibrillation Screening A Report From a National Heart, Lung, and Blood Institute Virtual Workshop

被引:56
作者
Benjamin, Emelia J. [1 ,2 ]
Go, Alan S. [3 ,4 ,5 ,6 ,7 ]
Desvigne-Nickens, Patrice [9 ]
Anderson, Christopher D. [11 ,12 ]
Casadei, Barbara [13 ]
Chen, Lin Y. [14 ]
Crijns, Harry J. G. M. [15 ]
Freedman, Ben [16 ,17 ]
Hills, Mellanie True [18 ]
Healey, Jeff S. [19 ]
Kamel, Hooman [20 ,21 ]
Kim, Dong-Yun [10 ]
Link, Mark S. [22 ]
Lopes, Renato D. [23 ,24 ]
Lubitz, Steven A. [25 ,26 ]
McManus, David D. [27 ]
Noseworthy, Peter A. [28 ]
Perez, Marco, V [29 ]
Piccini, Jonathan P. [23 ,24 ]
Schnabel, Renate B. [30 ,31 ]
Singer, Daniel E. [32 ,33 ]
Tieleman, Robert G. [34 ,35 ]
Turakhia, Mintu P. [8 ,36 ]
Van Gelder, Isabelle C. [34 ,35 ]
Cooper, Lawton S. [9 ]
Al-Khatib, Sana M. [23 ,24 ]
机构
[1] Boston Univ, Sch Med, Cardiovasc Med, Collamore 8,72 E Concord St, Boston, MA 02118 USA
[2] Boston Univ, Dept Epidemiol, Sch Publ Hlth, Boston, MA 02118 USA
[3] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA
[4] Univ Calif San Francisco, Dept Epidemiol Biostat & Med, San Francisco, CA 94143 USA
[5] Stanford Univ, Dept Med, Stanford, CA 94305 USA
[6] Stanford Univ, Dept Hlth Res, Stanford, CA 94305 USA
[7] Stanford Univ, Dept Policy, Stanford, CA 94305 USA
[8] Stanford Univ, Stanford, CA 94305 USA
[9] NHLBI, Div Cardiovasc Sci, NIH, Bldg 10, Bethesda, MD 20892 USA
[10] NHLBI, Off Biostat Res, NIH, Bldg 10, Bethesda, MD 20892 USA
[11] Massachusetts Gen Hosp, Dept Neurol, Ctr Genom Med, Boston, MA 02114 USA
[12] Massachusetts Gen Hosp, McCance Ctr Brain Hlth, Boston, MA 02114 USA
[13] Univ Oxford, Radcliffe Dept Med, Div Cardiovasc Med, Oxford, England
[14] Univ Minnesota, Sch Med, Dept Med, Cardiovasc Div, Minneapolis, MN 55455 USA
[15] Maastricht Univ, Cardiovasc Res Inst Maastricht, Dept Cardiol, Med Ctr, Maastricht, Netherlands
[16] Univ Sydney, Heart Res Inst, Charles Perkins Ctr, Concord Clin Sch, Sydney, NSW, Australia
[17] Univ Sydney, Concord Hosp, Dept Cardiol, Concord Clin Sch, Sydney, NSW, Australia
[18] Amer Fdn Womens Hlth, StopAfib Org, Decatur, GA USA
[19] McMaster Univ, Populat Hlth Res Inst, Hamilton, ON, Canada
[20] Weill Cornell Med, Feil Family Brain & Mind Res Inst, Clin & Translat Neurosci Unit, New York, NY USA
[21] Weill Cornell Med, Dept Neurol, New York, NY USA
[22] UT Southwestern Med Ctr, Dept Med, Div Cardiol, Dallas, TX USA
[23] Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA
[24] Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USA
[25] Harvard Med Sch, Cardiovasc Res Ctr, Massachusetts Gen Hosp, Boston, MA 02115 USA
[26] Harvard Med Sch, Cardiac Arrhythmia Serv, Massachusetts Gen Hosp, Boston, MA 02115 USA
[27] Univ Massachusetts, Dept Med, Div Cardiol, Worcester, MA 01605 USA
[28] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA
[29] Stanford Univ, Div Cardiovasc Med, Med Ctr, Stanford, CA 94305 USA
[30] Univ Heart & Vasc Ctr, Dept Cardiol, Hamburg, Germany
[31] DZHK German Ctr Cardiovasc Res, Partner Site Hamburg Kiel Luebeck, Hamburg, Germany
[32] Massachusetts Gen Hosp, Div Gen Internal Med, Boston, MA 02114 USA
[33] Harvard Med Sch, Boston, MA 02114 USA
[34] Univ Groningen, Dept Cardiol, Univ Med Ctr Groningen, Groningen, Netherlands
[35] Martini Hosp, Dept Cardiol, Groningen, Netherlands
[36] Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA USA
基金
欧洲研究理事会; 欧盟地平线“2020”;
关键词
atrial fibrillation; diagnostic screening programs; prevention and control; research; stroke; AUSTRALIAN CLINICAL GUIDELINES; RHYTHM MONITORING STRATEGIES; TRANSIENT ISCHEMIC ATTACK; EHRA CONSENSUS DOCUMENT; SOCIEDAD LATINOAMERICANA; COMPREHENSIVE EVALUATION; ORAL ANTICOAGULANTS; CARDIAC SOCIETY; PRIMARY-CARE; RISK-FACTORS;
D O I
10.1161/CIRCULATIONAHA.120.047633
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Clinically recognized atrial fibrillation (AF) is associated with higher risk of complications, including ischemic stroke, cognitive decline, heart failure, myocardial infarction, and death. It is increasingly recognized that AF frequently is undetected until complications such as stroke or heart failure occur. Hence, the public and clinicians have an intense interest in detecting AF earlier. However, the most appropriate strategies to detect undiagnosed AF (sometimes referred to as subclinical AF) and the prognostic and therapeutic implications of AF detected by screening are uncertain. Our report summarizes the National Heart, Lung, and Blood Institute's virtual workshop focused on identifying key research priorities related to AF screening. Global experts reviewed major knowledge gaps and identified critical research priorities in the following areas: (1) role of opportunistic screening; (2) AF as a risk factor, risk marker, or both; (3) relationship between AF burden detected with long-term monitoring and outcomes/treatments; (4) designs of potential randomized trials of systematic AF screening with clinically relevant outcomes; and (5) role of AF screening after ischemic stroke. Our report aims to inform and catalyze AF screening research that will advance innovative, resource-efficient, and clinically relevant studies in diverse populations to improve the diagnosis, management, and prognosis of patients with undiagnosed AF.
引用
收藏
页码:372 / 388
页数:17
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