WHF Roadmap for Non-Valvular Atrial Fibrillation

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The World Heart Federation Roadmap for Non-Valvular Atrial Fibrillation identifies roadblocks and suggests potential solutions to improve cardiovascular health and help reach the target set out in the Sustainable Development Goals: achieve a 30% reduction in NCDs, including CVD, by 2030.

This WHF Roadmap has been written by twelve experts from around the world: Murphy A, Banerjee A, Breithardt G, Camm J, Commerford P, Freedman B, Gonzales Hermosillo J, Halperin J, Lau C, Perel P, Xavier D, Wood D, Jouven X, and Morillo C.

A Roadmap is a framework to identify roadblocks and suggest potential solutions on the road to 2030. Global Roadmaps have been developed by worldwide experts to detect the problems and offer solutions on specific topics impacting cardiovascular mortality.

This Roadmap was launched on 3rd October 2016 at the WHF Roadmap event in Geneva, Switzerland, and has been published in Global Heart.

Overview

WHF has developed this roadmap with experts and its members to help identify the roadblocks and solutions. Whilst AF is not represented by a specific 25by25 target, it is a significant problem, in that it is often undiagnosed, and as a result a huge contributor to CVD premature mortality.

Challenges

Between 1990 and 2013, although the global prevalence rate of AF decreased slightly, the overall number of AF cases increased, according to the Global Burden of Disease Study (GBD) 2013. The morbidity burden associated with AF, as measured by disability-adjusted life years (DALYs), also increased. Estimates of prevalence of AF, and DALYs associated with AF, are likely to underestimate true burden due to the high prevalence of asymptomatic AF (8) AF is also associated with high costs incurred by individuals, health care systems and economies.

Target

Whilst Atrial Fibrillation is not represented by a specific 25by25 target, it is a significant problem, in that it is often undiagnosed, and as a result a huge contributor to CVD premature mortality. WHF has used the roadmap framework to give countries an insight into how this issue can be tackled, with the emphasis being on local adaptation and implementation strategies.

Definition

Atrial Fibrillation (AF) is associated with increased risk of stroke and is found in one third of all ischemic strokes. It is under-diagnosed and for this reason poises a significant burden of risk and economic cost, which, could be managed and reduced if diagnosed more effectively. AF is the commonest clinically significant arrhythmia. Consequences of AF can include, increased mortality, increased risk and severity of stroke, increased risk of hospitalization, reduction in quality of life, reduction of exercise capacity and increased risk of heart failure.

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