2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof, Paulus; Benussi, Stefano; Kotecha, Dipak; Ahlsson, Anders; Atar, Dan; Casadei, Barbara; Castellà, Manuel; Diener, Hans‐Christoph; Heidbüchel, Hein; Hendriks, Jeroen; Hindricks, Gerhard; Manolis, Antonis S; Oldgren, Jonas; Popescu, Bogdan A; Schotten, Ulrich; Putte, Bart Van de; Vardas, Panagiotis; Agewall, Stefan; Camm, John; Barón-Esquivias, Gonzalo; Budts, Werner; Carerj, Scipione; Casselman, Filip; Coca, António; Caterina, Raffaele De; Deftereos, Spyros; Dobrev, Dobromir; Ferro, José M.; Filippatos, Gerasimos; Fitzsimons, Donna; Görenek, Bülent; Guenoun, Maxine; Hohnloser, Stefan H.; Kolh, Philippe; Lip, Gregory Y.H.; Manolis, Athanasios; McMurray, John J.V.; Ponikowski, Piotr; Rosenhek, Raphaël; Ruschitzka, Frank; Savelieva, Irina; Sharma, Sanjay; Suwalski, Piotr; Tamargo, Juan; Taylor, Clare; Gelder, Isabelle C. Van; Voors, Adriaan A.; Windecker, Stephan; Zamorano, José Luís; Zeppenfeld, Katja

doi:10.1093/ejcts/ezw313

Cited by 930 publications

(742 citation statements)

References 1,018 publications

(211 reference statements)

Supporting

Mentioning

625

Contrasting

Unclassified

Order By: Relevance

“…Dose adjustments are suggested in patients with eGFR between 50 and 30 mL/min for rivaroxaban and edoxaban as well as in patients with creatinine >1.5 mg/dL plus age ≥80 years or weight ≤60 kg for apixaban [19]. These indications are derived from post hoc analysis of the large trials comparing warfarin with the new drugs (see below).…”

Section: Novel Oral Anticoagulants and Ckdmentioning

confidence: 99%

“…European Society of Cardiology (ESC), American Heart Association (AHA) and American College of Cardiology (ACC) Guidelines recommend using the CHA2DS2-VASc Score to assess the risk of stroke in patients with AF. ESC Guidelines [19] recommend patients with risk factor(s) ≥1 to receive effective stroke prevention therapy. Antithrombotic therapy is not recommended in patients with AF (irrespective of gender) who are <65 years old and with lone AF, as they have very low absolute event rates.…”

Section: Percutaneous Laa Occlusionmentioning

confidence: 99%

See 1 more Smart Citation

Recent Advances in Stroke Prevention in Patients with Atrial Fibrillation and End-Stage Renal Disease

Ronco¹,

Mazzone

Hosseinian

et al. 2017

Cardiorenal Med

View full text Add to dashboard Cite

Background: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. Summary: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA. Limited data from post hoc analyses of controlled clinical trials suggest the safe and effective use of NOACs in patients with moderate renal impairment (i.e., estimated glomerular filtration rate, eGFR, between 30 and 50 mL/min). The question still remains whether NOACs can be used in patients with an eGFR <30 mL/min, since there are no studies addressing this subject. In fact, patients with CKD stage 4 and 5 were excluded from controlled clinical trials on anticoagulation therapy for stroke prevention in AF. Left atrial appendage (LAA) occlusion represents a nonpharmacological alternative for stroke prevention in patients with AF who are difficult to manage medically. Preliminary data indicate a similar efficacy and safety profile in patients with CKD compared to patients with normal renal function. Key Messages: Stroke prevention in patients with ESRD and AF represents a clinical challenge with poor evidence. LAA occlusion may become the standard of care for stroke prevention in patients with ESRD and AF.

show abstract

Section: Novel Oral Anticoagulants and Ckdmentioning

confidence: 99%

Section: Percutaneous Laa Occlusionmentioning

confidence: 99%

Recent Advances in Stroke Prevention in Patients with Atrial Fibrillation and End-Stage Renal Disease

Ronco¹,

Mazzone

Hosseinian

et al. 2017

Cardiorenal Med

View full text Add to dashboard Cite

show abstract

“…n Adapted from Ehrlich et al, 2013 5 In 2016, a core group formulated and published the most recent European Society of Cardiology (ESC) guidelines for the management of AF. 7 These guidelines were the focus of their own session, starting with an overview and then a closer look at some of the significantly modified recommendations pertaining to the treatment of AF.…”

Section: Focal Triggersmentioning

confidence: 99%

“…The most common serious complications of AF ablation are cardiac tamponade and vascular complications, 7 and many other issues that cannot be prevented by keeping patients in overnight. "It's not suitable for everyone, but day-case AF ablation is feasible for some patients," said Prof Schilling.…”

Section: Protagonistmentioning

confidence: 99%

16th Atrial Fibrillation Symposium

Wasek¹

2017

Arrhythmia &Amp; Electrophysiology Review

View full text Add to dashboard Cite

A trial fibrillation (AF) currently affects 2 % of the population, with estimates that by 2030, 14-17 million people in Europe will experience AF. 1 This debilitating condition is fast becoming a critical public health issue. To improve education and care in this area, Biosense Webster has developed ground-breaking innovations and has sponsored this educational symposium for 16years. This year's symposium took place on 22-24 March 2017 in The Hague, the Netherlands, and welcomed an international faculty to present an agenda that reflected the newest developments, research and perspectives in AF treatment.The Atrial Fibrillation Practical Sessions were conducted on the first day and focused on all aspects of the AF ablation procedure and the practical usage of new technologies in the field of AF ablation. The high-level lectures were case-based and geared towards improving procedure workflow and, ultimately, improving patient care. International expert faculty shared experiences from their practice, as well as tips and tricks. The target audience was physicians looking to perfect their procedure workflows, enhancing efficacy, efficiency and safety through the sharing of knowledge.The next two days comprised the Atrial Fibrillation Symposium, where international faculties presented the newest developments and research results, some prior to publication. The target audience was skilled AF practitioners seeking the most progressive information in this field to advance their knowledge and practice. Interactive polling via handheld devices provided real-time insights, in addition to engagement through Q&A sessions during each panel discussion. Attendees received up to 10 hours of CME for their participation.In welcoming attendees to the 16th Atrial Fibrillation Symposium, Prof Dipen Shah of Geneva, Switzerland, said: "This year's programme has been put together to emphasise currently relevant themes and threads in the field of AF and its treatment by catheter ablation. Although AF has an undeniably characteristic electrical signature, the increasing awareness and understanding of causative sequelae and associated structural abnormalities in the atria have led to the acknowledgement of atrial cardiomyopathy as a distinct entity. The symposium's scientific intent will therefore kick off with an exposition of this. It is my sincere hope that you will enjoy the proceedings as much as I and my colleagues in the scientific committee did putting the programme together."Prof Dipen Shah giving the welcome to symposium attendees.

show abstract

“…Favorable results were reported for a treatment strategy with dual therapy (DT) using single antiplatelet therapy plus vitamin K antagonists (VKAs) after PCI [7–10]. Novel oral anticoagulants (NOACs) are suitable alternatives to VKAs for stroke prevention in non-valvular AF and their use in clinical practice is increasing rapidly [11], also driven by guideline recommendation as first-line preference [12]. DT using NOACs and P2Y 12 inhibitors may replace TT in AF patients with PCI, but so far, many questions are still open regarding this new antithrombotic strategy.…”

Section: Introductionmentioning

confidence: 99%

Dual Antithrombotic Therapy with Clopidogrel and Novel Oral Anticoagulants in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Real-world Study

et al. 2018

View full text Add to dashboard Cite

IntroductionFor patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI), proper antithrombotic therapy is equivocal. Current guidelines recommend triple therapy, which carries a high risk of bleeding. Recent large trials suggest that dual therapy (DT) with novel oral anticoagulant (NOAC) plus P2Y12 inhibitor can be an appropriate alternative, but real-world data for this alternative are scarce and the optimal duration of DT has not yet been established.MethodsThis analysis was performed in a single-center prospective cohort. We investigated 216 PCI patients with indication for anticoagulation due to AF. After PCI patients received DT with reduced doses NOAC plus P2Y12 inhibitor for 6 months, which was followed by standard dose NOAC monotherapy. Efficacy endpoints were defined as cardiac death, myocardial infarction (MI), stent thrombosis (ST), and stroke. Safety endpoints were bleeding events as defined by Bleeding Academic Consortium (BARC).ResultsBaseline characteristics of our study population were described by a CHA2DS2-VASc score of greater than 4 and a HAS-BLED score of greater than 3. After a mean follow-up of 18.7 months, efficacy events occurred in 12 patients (5.6%). We observed three (1.4%) cardiac deaths, two (0.9%) MIs, six (2.8%) strokes, and one (0.5%) definite ST. After switching from DT to NOAC monotherapy after 6.3 ± 1.7 months, there was no rebound of ischemic events. Bleeding events occurred in 34 patients (15.7%) mainly under DT, while bleeding was less during NOAC monotherapy.ConclusionsIn this long-term study of high-risk and real-world AF-patients with PCI, DT with NOAC and P2Y12 inhibitor (6 months) followed by NOAC monotherapy was safe and effective.

show abstract

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Cited by 930 publications

References 1,018 publications

Recent Advances in Stroke Prevention in Patients with Atrial Fibrillation and End-Stage Renal Disease

Recent Advances in Stroke Prevention in Patients with Atrial Fibrillation and End-Stage Renal Disease

16th Atrial Fibrillation Symposium

Dual Antithrombotic Therapy with Clopidogrel and Novel Oral Anticoagulants in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Real-world Study

Contact Info

Product

Resources

About