Recent-onset atrial fibrillation: challenges and opportunities

作者：Emma Svennberg, Ben Freedman, Jason G. Andrade, Matteo Anselmino, Yitschak Biton, Giuseppe Boriani, Axel Brandes, Claire Buckley, Alan C. Cameron, Josep Lluís Clua‐Espuny, Harry J.G.M. Crijns, Søren Zöga Diederichsen, Wolfram Doehner, Helena Domínguez, David Duncker, Laurent Fauchier, Taya V. Glotzer, Yutao Guo, Karl Georg Hæusler, Moti Haim, Jeff S. Healey, Jeroen Hendriks, Mellanie True Hills, Gerhard Hindricks, Richard Hobbs, Linda Johnson, Boyoung Joung, Hooman Kamel, Paulus Kirchhof, Deirdre A. Lane, Lars‐Åke Levin, Gregory Y.H. Lip, Shaowen Liu, Trudie Lobban, Peter W. Macfarlane, Georges H. Mairesse, Gregory M. Marcus, Peter A. Noseworthy, George Ntaios, J. Orchard, Rod Passman, Daniel D. Reidpath, James A. Reiffel, Antônio Luiz Pinho Ribeiro, Léna Rivard, Prashanthan Sanders, Roopinder K. Sandhu, Renate B. Schnabel, Konstantinos C. Siontis, Luciano A. Sposato, Stavros Stavrakis, Steven R. Steinhubl, Jesper Hastrup Svendsen, A. Teh, Sakis Themistoclakis, Robert G Tieleman, A. John Camm · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf478 · 被引用次数：14 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiac Arrhythmias and Treatments、Venous Thromboembolism Diagnosis and Management

Atrial fibrillation (AF) is increasingly diagnosed early, close to its first occurrence due to: (i) increased public awareness with self-screening; (ii) health care initiatives including population screening and opportunistic case finding; and (iii) increased use and surveillance of implantable cardiac devices. At its onset, AF is often low burden, and cardiovascular co-morbidities may be absent or at an early stage. Thus, the management of recent-onset AF has become an issue of growing importance. Professional guidelines have traditionally focused on anticoagulant thromboprophylaxis, generally recommending a cautious approach to rhythm control, and priority has been given to rate control to alleviate symptoms. In recent guidelines, the importance of managing lifestyle and co-morbidities has increased. The AF-SCREEN collaboration proposes that a vigorous approach to active management of recent-onset AF may be warranted. This includes addressing co-morbidities and promoting healthy lifestyles to prevent the emergence or progression of AF and associated cardiovascular disease, as well as the initiation of active rhythm control ± anticoagulation to prevent AF-related morbidity and mortality, including stroke and heart failure (HF). Intuitively, intervention early after AF onset would be beneficial since lifestyle and co-morbidity management, plus rhythm control and anticoagulation, are important contributors to improved outcomes in patients with established AF, but robust eviden...