With an ageing population in Europe and the prevalence of atrial fibrillation expected to double in the continent by 2060, Atrial Fibrillation (AF) looks likely to become a future health issue for millions of people in Europe.

The Future of Anticoagulation Report, launched in Brussels today, explores how decisions made today can change and reshape the landscape of tomorrow and have the potential to make a significant difference in changing the direction of this disease in terms of prevalence and impact.

Atrial fibrillation, a disorder of the rhythm of the heart, is expected to be a leading health burden in the EU in the coming years. AF is the most common sustained arrhythmia in the general population, affecting approximately 1.5 to two per cent of the population in the developed world.

A heart rhythm disorder may remain ‘silent’, asymptomatic and undiscovered for months or even years. However, its eventual consequences can be very damaging and are associated with significant morbidities and mortality. AF is associated with a five times higher risk of stroke and a three times higher risk of heart failure. Strokes that result from AF are more severe and are associated with a high risk of mortality (32.8 per cent) and with a 50 per cent probability of remaining disabled or handicapped within three months of having a stroke.

Therefore, the increasing number of adults with AF will have major public health implications across Europe over the forthcoming decades. Although new medical therapies have been developed and recommendations for diagnosis and treatments aligned in Europe in the last few years, AF is still under or not treated in many cases.

Researched and written with contributions from a panel of leading European medical, patient group and health economic experts the report outlines three primary short-term recommendations: improve AF awareness among the public and policymakers, support education about AF management for healthcare professionals and patients, and maintain AF related research across the health services to be able to monitor what works best in terms of healthcare interventions.

“This report is a wake-up call for healthcare professionals and policymakers across Europe to work together to better manage AF, as its burden looks set to double as our population ages,” explains John Camm, chair of the Future of Anticoagulation Steering Committee, professor of clinical cardiology, St George’s, University of London and professor of cardiology, Imperial College London, the UK.

 “I would especially like to highlight that we need to improve healthcare policies related to AF, including improving diagnosis and supporting earlier treatment interventions, such as effective modern anticoagulant medicines, to ensure that we can ultimately prevent avoidable deaths across the continent.”

The study aims were to assess the current landscape and challenges for the management of AF in Europe, and explore how this landscape could evolve. It focused on six key countries in Europe; Belgium, France, Germany, Italy, Spain and the UK.

The two main goals of the study were to develop an evidence base on the current reality of AF-related anticoagulation management in these six countries and to develop an understanding of actions that could be taken today to improve the outlook for future AF management. T

he methods of research comprised a literature review and assessment, and 60 interviews carried out with a range of experts representing various stakeholder groups such as healthcare professionals, patient representatives and policymakers. In addition, a steering committee made up of 10 experts in cardiology and related areas from the six European focus countries and an international patient group representative were actively involved in the development of the report.

Detecting an irregular heart rhythm might be as simple as a manual pulse check, with any unusual rhythm verified with an electrocardiogram (ECG).

Trudie C. Lobban, founder & CEO of Atrial Fibrillation Association (AFA) explained: “Lives can be saved if only people begin to regularly check their pulse. Early diagnosis is more challenging if few people know about AF or its symptoms, and if AF goes undiagnosed, opportunities for earlier interventions and treatment to prevent AF-related stroke are missed entirely. The Atrial Fibrillation Association welcomes this timely report that underscores how important it is to detect, protect and correct heart rhythm disorders across the EU.”

The report’s longer-term recommendations include: (i) taking a longer-term view in decisions on spending for AF awareness, education, care and management that are considered vital for improving health outcomes; (ii) there is a need for continued improvement in patient stratification (such as based on biomarkers or health imaging) that can lead to enhanced personalisation of treatment and medical care; (iii) there needs to be greater interaction among primary, community, secondary and tertiary healthcare professionals to enable greater knowledge sharing and more whole-patient approaches to care; and finally (iv) enhancing monitoring via developments in devices and data is also needed to maximise benefits of AF management.