Liverpool contributes to new guidelines for common heart condition

heart monitor

Researchers from the Liverpool Centre for Cardiovascular Science have contributed to a potentially life saving set of clinical guidelines, advising on novel approaches to improve the detection and treatment of Atrial Fibrillation (AF).

Adults have a 1 in 4 lifetime risk of developing the condition, making AF the most common heart rhythm disorder. AF is associated with a high risk of stroke, death, dementia and heart failure.

On 29 August 2020, new evidence-based guidelines for the management of AF were published by the European Society of Cardiology (ESC) and presented at the virtual ESC congress.

The guidelines writing group included two University of Liverpool researchers, Professor Gregory Lip and Dr Deirdre Lane.

Research outputs from the Liverpool team, including evidence-based stroke and bleeding risk assessments (the CHA2DS2-VASc and HAS-BLED scores) and a new approach to streamlining the management of atrial fibrillation, the ABC, (Atrial fibrillation Better Care) contributed to the new guidelines.

The ABC pathway refers to: ‘A’ Avoid stroke with Anticoagulation; ‘B’ Better symptom management with patient-centred symptom directed rate or rhythm control; ‘C’ Cardiovascular risk and Comorbidity management, including lifestyle changes.

This provides a simple and streamlined approach to AF care, that can be followed by general and hospital practitioners and is easily understood by patients (Easy as ABC…).

Professor Lip, Director of the Liverpool Centre for Cardiovascular Science, said: “We are honoured to be part of this major European initiative, and very pleased that our research has made a major impact on these new guidelines which have global impact. It’s great to see how our research into atrial fibrillation can help improve the care and management of patients with this common heart rhythm condition.”

Associate Professor Tatjana Potpara, Chairperson of the Task Force for the new AF guidelines, said: “The 2020 ESC AF Guidelines not only reflect the evidence accumulated since 2016 when the previous guidelines were issued, but further streamline the management of patients with AF across all healthcare levels, starting from the screening for the arrhythmia to the diagnosis and structured characterization of AF using the 4S-AF scheme, and the holistic ABC pathway for the management of patients. There are also quality standards for AF care, issued by the ESC to accompany the new guidelines.”

Mrs Trudie Lobban, CEO of the Atrial Fibrillation Association, added: “Updated guidelines are welcomed to improve the care and management of AF. The stress and anxiety caused by AF to the millions of patients worldwide cannot be under estimated and yet with early detection and diagnosis, protection against AF-related stroke with appropriate anticoagulation therapy and correction of the irregular heart rhythm with advancing treatment options, patients can live more active, less stressful, lives. The ESC guidelines and the inclusion of the ABC pathway can only lead to better outcomes and improved quality of life for all those living with AF.”

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ESC guidelines; Eur Heart J 2020; doi:10.1093/eurheartj/ehaa612

4S-AF scheme to characterise atrial fibrillation; Thromb Haemostat 2020; doi: 10.1055/s-0040-1716408.