Practical Comprehensive Approach to Current Atrial Fibrillation Challenges: Insights from an Expert Panel

Background/Objectives: Atrial fibrillation (AF) is a very common arrhythmia and the main cause of embolic events. Early diagnosis and treatment are crucial to prevent thromboembolic events. Although DOACs are an important advance in AF management, optimization is required. This study aims to evaluat...

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Detalles Bibliográficos
Autores: Escobar, Carlos, Camafort, Miguel, Fortuny Frau, Elena, Grymonprez, Maxim, Pérez-Cabeza, Alejandro Isidoro, de Backer, Tine L.
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/25719
Acceso en línea:https://hdl.handle.net/20.500.13003/25719
Access Level:acceso abierto
Palabra clave:Medication Adherence
Atrial Fibrillation
Catheter Ablation
Hemorrhage
Cumplimiento de la Medicación
Fibrilación Atrial
Ablación por Catéter
Hemorragia
adherence
ageing
atrial fibrillation
catheter ablation
comorbidity
hemorrhage
oral anticoagulation
thromboembolic risk
Descripción
Sumario:Background/Objectives: Atrial fibrillation (AF) is a very common arrhythmia and the main cause of embolic events. Early diagnosis and treatment are crucial to prevent thromboembolic events. Although DOACs are an important advance in AF management, optimization is required. This study aims to evaluate the newly available evidence and experts’ opinions on the clinical care of AF patients and to develop a set of practical recommendations to improve the management of patients with AF. Methods: A questionnaire was developed on the topics of AF diagnosis, stroke prevention, rate and rhythm control, and management of comorbidities, based on the scientific committee’s judgment and a rapid literature review. The level of agreement of the panelists with each statement was evaluated using the Likert 5-point scale. The results of the questionnaire were discussed in a final meeting and practical recommendations were made. Results: Thirty-five Spanish panelists, all experts in AF management, answered the questionnaire. Most of the statements (78%) reached the levels of agreement or unanimity. Discrepancy (9%) and rejection (13%) were also reported. Conclusions: This study underscores the importance of a 12-lead electrocardiogram to diagnose AF, with wearable devices serving as useful tools; catheter ablation as a superior strategy for restoring and maintaining sinus rhythm compared to pharmacotherapy; the importance of comorbidity management to reduce incidence and recurrence of AF; adherence and persistence as critical factors for the efficacy and safety of anticoagulation; and the preference for DOACs, particularly apixaban and edoxaban, for stroke prevention in patients ≥75 years old or with chronic kidney disease.