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Roadmap on Atrial Fibrillation

The World Heart Federation Roadmap on 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.

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.

In 2017, the World Heart Federation published a Roadmap for Non-Valvular Atrial Fibrillation, which provided evidence-informed guidance on priority interventions for AF that can be adapted to different contexts.

Since then, technological advances have created new opportunities to help overcome barriers to screening, diagnosis and management of AF, from devices that can help identify and predict the condition, to the use of mobile technologies to facilitate new, more efficient and more effective approaches to healthcare.

In 2019, thanks to a team of WHF Emerging Leaders, the World Health Organisation added non-vitamin K antagonist oral anticoagulants, which are crucial for stroke prevention and for the management of AF, to its Model List of Essential Medicines.

Three years after the original Roadmap publication, the barriers and solutions that were identified continue to be relevant. Our new, updated Roadmap focuses on reviewing what has changed and redefining global priorities for AF management, particularly targeting low- and middle-income countries.

This includes:

  • Advocacy campaigns to increase awareness of the scope of the problem
  • Educational interventions targeting both healthcare providers and patients
  • Efforts to improve access to affordable diagnosis and treatment
  • And use of available technologies to improve AF screening, diagnosis and management

The updated WHF Roadmap on Atrial Fibrillation is a key reference document for anyone involved in the planning, organization, patient management and implementation of approaches to reduce the burden of AF.

The original ‘World Heart Federation Roadmap for Nonvalvular Atrial Fibrillation’ was published in Global Heart in December 2017.

The updated ‘World Heart Federation Roadmap on Atrial Fibrillation – A 2020 Update’ was published in Global Heart in May 2021.

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

Atrial Fibrillation is a significant problem because 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.

Download the Roadmap