Matches in SemOpenAlex for { <https://semopenalex.org/work/W3021496777> ?p ?o ?g. }
- W3021496777 endingPage "40" @default.
- W3021496777 startingPage "4" @default.
- W3021496777 abstract "Atrial fibrillation (AF) is an important and highly prevalent arrhythmia, which is associated with significantly increased morbidity and mortality, including a four- to five-fold increased risk for stroke,1,2 a two-fold increased risk for dementia,3,4 a three-fold risk for heart failure,2 a two-fold increased risk for myocardial infarction,5,6 and a 40–90% increased risk for overall mortality.2,7 The constantly increasing number of AF patients and recognition of increased morbidity, mortality, impaired quality of life, safety issues, and side effects of rhythm control strategies with antiarrhythmic drugs, and high healthcare costs associated with AF have spurred numerous investigations to develop more effective treatments for AF and its complications.8 Although AF treatment has been studied extensively, AF prevention has received relatively little attention, while it has paramount importance in the prevention of morbidity and mortality, and complications associated with arrhythmia and its treatment. Current evidence shows a clear association between the presence of modifiable risk factors and the risk of developing AF.By implementing AF risk reduction strategies aiming at risk factors such as obesity, hypertension, diabetes, and obstructive sleep ap-noea (OSA), which are interrelated, we impact upon the escalating incidence of AF in the population and ultimately decrease the healthcare burden of associated co-morbidities of AF.To address this issue, a Task Force was convened by the European Heart Rhythm Association and the European Association of Cardiovascular Prevention and Rehabilitation, endorsed by the Heart Rhythm Society and Asia-Pacific Heart Rhythm Society, with the remit to comprehensively review the published evidence available, to publish a joint consensus document on the prevention of AF, and to provide up-to-date consensus recommendations for use in clinical practice. In this document, our aim is to summarize the current evidence on the association of each modifiable risk factor with AF and the available data on the impact of possible interventions directed at these factors in preventing or reducing the burden of AF. While the evidence on AF prevention is still emerging, the topic is not fully covered in current guidelines and some aspects are still controversial. Therefore, there is a need to provide expert recommendations for professionals participating in the care of at-risk patients and populations, with respect to addressing risk factors and lifestyle modifications.Health economic considerationsAtrial fibrillation is a costly disease, both in terms of direct, and indirect costs, the former being reported by cost of illness studies as per-patient annual costs in the range of US $2000–14200 in North America and of €450–3000 in Europe.9In individuals with AF or at risk of developing AF, any effective preventive measure, intervention on modifiable risk factors or comorbidities, as well as any effective pharmacological or non-pharmacological treatment has the aim to reduce AF occurrence, thromboembolic events and stroke, morbidity and, possibly, mortality related to this arrhythmia. Apart from the clinical endpoints, achievement of these goals has economic significance, in terms of positive impact on direct and indirect costs and favourable cost–effectiveness at mid- or long-term, in the perspective of healthcare systems.10–12In view of the epidemiological profile of AF and progressive aging of the population,13 an impressive increase of patients at risk of AF or affected by AF,14 also in an asymptomatic stage, is expected in the next decades, inducing a growing financial burden on healthcare systems, not only in Europe and North America, but also worldwide.15,16In consideration of this emerging epidemiological threat due to AF, it is worth considering a paradigm shift, going beyond the conventional approach of primary prevention based on treatment of AF risk factors, but, instead, considering the potential for ‘primordial’ prevention, defined as prevention of the development of risk factors predisposing to AF in the first place.17 This approach, aimed at avoiding the emergence and penetration of risk factors into the population, has been proposed in general terms for the prevention of cardiovascular diseases17 and should imply combined efforts of policymakers, regulatory and social service agencies, providers, physicians, community leaders, and consumers, in an attempt to improve social and environmental conditions, as well as individual behaviours, in the pursuit of adopting healthy lifestyle choices.16 Since a substantial proportion of incident AF events can be attributable to elevated or borderline levels of risk factors for AF,18 this approach could be an effective way to reduce the financial burden linked to AF epidemiology. In terms of individual behaviour and adoption of a ‘healthy lifestyle’, it is worth considering that availability of full healthcare coverage (through health insurance or the healthcare system) may in some cases facilitate the unwanted risk of reducing, at an individual level, the motivation to adopt all the preventive measures that are advisable, in line with the complex concept of ‘moral hazard effect’.19 Patient education and patient empowerment are the correct strategies for avoiding this undesirable effect." @default.
- W3021496777 created "2020-05-13" @default.
- W3021496777 creator A5000933955 @default.
- W3021496777 creator A5002549918 @default.
- W3021496777 creator A5004258066 @default.
- W3021496777 creator A5005773814 @default.
- W3021496777 creator A5009368105 @default.
- W3021496777 creator A5010781972 @default.
- W3021496777 creator A5012570915 @default.
- W3021496777 creator A5019069948 @default.
- W3021496777 creator A5023972061 @default.
- W3021496777 creator A5025957064 @default.
- W3021496777 creator A5028979797 @default.
- W3021496777 creator A5033166833 @default.
- W3021496777 creator A5033902499 @default.
- W3021496777 creator A5033941596 @default.
- W3021496777 creator A5038405190 @default.
- W3021496777 creator A5039541572 @default.
- W3021496777 creator A5041226897 @default.
- W3021496777 creator A5044262070 @default.
- W3021496777 creator A5046313850 @default.
- W3021496777 creator A5047995526 @default.
- W3021496777 creator A5048738698 @default.
- W3021496777 creator A5053752784 @default.
- W3021496777 creator A5057811781 @default.
- W3021496777 creator A5058870689 @default.
- W3021496777 creator A5060493125 @default.
- W3021496777 creator A5062476698 @default.
- W3021496777 creator A5063047493 @default.
- W3021496777 creator A5064309113 @default.
- W3021496777 creator A5067779338 @default.
- W3021496777 creator A5078667862 @default.
- W3021496777 creator A5079314197 @default.
- W3021496777 creator A5086153061 @default.
- W3021496777 creator A5089791329 @default.
- W3021496777 creator A5090763481 @default.
- W3021496777 date "2016-11-04" @default.
- W3021496777 modified "2023-10-18" @default.
- W3021496777 title "European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS)" @default.
- W3021496777 cites W107170187 @default.
- W3021496777 cites W13098407 @default.
- W3021496777 cites W140098974 @default.
- W3021496777 cites W1510901277 @default.
- W3021496777 cites W1568095913 @default.
- W3021496777 cites W1573265559 @default.
- W3021496777 cites W1588801283 @default.
- W3021496777 cites W1598196656 @default.
- W3021496777 cites W1680770482 @default.
- W3021496777 cites W168386259 @default.
- W3021496777 cites W17250226 @default.
- W3021496777 cites W1759786936 @default.
- W3021496777 cites W1786577233 @default.
- W3021496777 cites W1794865490 @default.
- W3021496777 cites W1805190232 @default.
- W3021496777 cites W1814319499 @default.
- W3021496777 cites W1844545278 @default.
- W3021496777 cites W1862256692 @default.
- W3021496777 cites W1890486457 @default.
- W3021496777 cites W1909499079 @default.
- W3021496777 cites W1924098982 @default.
- W3021496777 cites W1934330082 @default.
- W3021496777 cites W1951132801 @default.
- W3021496777 cites W1963940525 @default.
- W3021496777 cites W1964591839 @default.
- W3021496777 cites W1965556771 @default.
- W3021496777 cites W1965686740 @default.
- W3021496777 cites W1966297507 @default.
- W3021496777 cites W1967405452 @default.
- W3021496777 cites W1970242617 @default.
- W3021496777 cites W1970428542 @default.
- W3021496777 cites W1970914415 @default.
- W3021496777 cites W1971664482 @default.
- W3021496777 cites W1972381900 @default.
- W3021496777 cites W1974266173 @default.
- W3021496777 cites W1974950104 @default.
- W3021496777 cites W1975777837 @default.
- W3021496777 cites W1976872170 @default.
- W3021496777 cites W1976946101 @default.
- W3021496777 cites W1977491109 @default.
- W3021496777 cites W1980051680 @default.
- W3021496777 cites W1983960180 @default.
- W3021496777 cites W1984022271 @default.
- W3021496777 cites W1984364985 @default.
- W3021496777 cites W1984571479 @default.
- W3021496777 cites W1985229307 @default.
- W3021496777 cites W1985320908 @default.
- W3021496777 cites W1985356125 @default.
- W3021496777 cites W1986316647 @default.
- W3021496777 cites W1986732974 @default.
- W3021496777 cites W1988209263 @default.
- W3021496777 cites W1988715175 @default.
- W3021496777 cites W1992944164 @default.
- W3021496777 cites W1995267173 @default.
- W3021496777 cites W1997601961 @default.
- W3021496777 cites W1998641072 @default.
- W3021496777 cites W1999556683 @default.
- W3021496777 cites W1999932345 @default.
- W3021496777 cites W2000103335 @default.