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New evidence beyond guidelines in atrial fibrillation

  • New developments in the diagnosis of atrial fibrillation, presented by G Hindricks (Leipzig, DE) - Slides
  • New antithrombotic therapies: revisiting stroke prevention in atrial fibrillation, presented by L C Wallentin (Uppsala, SE) - Slides
  • Rate and rhythm control in atrial fibrillation: redefining goals, presented by I Savelieva (London, GB)
  • Will catheter ablation of atrial fibrillation withstand the test of randomised studies, presented by S Ernst (London, GB) - Slides
Atrial Fibrillation


This main session chaired by J. CAMM (London, UK) and J.Y. LE HEUZEY (Paris, FR) has brought an interesting update concerning specifi c aspects of atrial fibrillation (AF).

New developments in the diagnosis of atrial fibrillation

The diagnosis of AF may be difficult when the symptoms are not obvious. Important researches are ongoing in order to assess the interest of implantable loop recorders, as pointed out by G. HINDRICKS (Leipzig, DE). Their interest may be emphasized in specific situations like the follow up of patients after ablation, or the decision of anticoagulation.

New antithrombotic therapies: revisiting stroke prevention in atrial fibrillation

New antithrombotic drugs are demonstrating their efficacy versus warfarine in stroke prevention. L. WALLENTIN (Uppsala, SE) has shown the main results of RELY, ROCKETAF and ARISTOTLE with Dabigatran, Rivaroxaban and Apixaban, making a comparison between the different parameters studied in all the trials. The main interest of these drugs is that, as compared to warfarin, they induce much fewer intracranial haemorrhages.

Rate and rhythm control in atrial fibrillation: redefining goals

I. SAVELIEVA (London, UK) came back on the problem of the strategic choice, i.e. rate or rhythm control. Since the results of the AFFIRM trial, most of the arrhythmologists consider that the goals have to be redefined. The maintenance of sinus rhythm implies a better prognosis but it is necessary to avoid the side effects of drugs prescribed for maintenance or the complications of non-pharmacological techniques.

Will catheter ablation of atrial fibrillation withstand the test of randomised studies

Finally S. ERNST (London, UK) made a review of abative procedures and their results. Many studies have shown a superiority of ablative techniques as compared to antiarrhythmic drugs but it is necessary to know that most of these studies have been made in patients with a previous failure of antiarrhythmic drugs. New trials comparing anti-arrhythmic drugs and ablation in first intention are ongoing.

References


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New evidence beyond guidelines in atrial fibrillation

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.