World Heart Federation Roadmap on Atrial Fibrillation - A 2020 Update

Ben Freedman, Gerhard Hindricks, Amitava Banerjee, Adrian Baranchuk, Chi Keong Ching, Xin Du, Donna Fitzsimons, Jeff S Healey, Takanori Ikeda, Trudie C A Lobban, Amam Mbakwem, Calambur Narasimhan, Lis Neubeck, Peter Noseworthy, Daniel M Philbin, Fausto J Pinto, Joselyn Rwebembera, Renate B Schnabel, Jesper Hastrup Svendsen, Luis AguinagaElena Arbelo, Michael Böhm, Hasan Ali Farhan, F D Richard Hobbs, Antoni Martínez-Rubio, Claudio Militello, Nitish Naik, Jean Jacques Noubiap, Pablo Perel, Daniel José Piñeiro, Antonio Luiz Ribeiro, Janina Stepinska

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Abstract

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.
Original languageEnglish
Article number41
JournalGlobal heart
Volume16
Issue number1
DOIs
Publication statusPublished - 27 May 2021

Keywords

  • AF
  • NOACs
  • WHF
  • atrial fibrillation
  • cardiology
  • digital technology

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