AF Aware Cardiology Groups Call For Greater Awareness And Better Education On Atrial Fibrillation
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Four leading patient and medical associations announced the formation of AF AWARE (Atrial Fibrillation AWareness And Risk Education), a joint initiative to highlight and address issues that contribute to the growing burden of atrial fibrillation (AF) worldwide.
AF is a common yet under-recognised and poorly understood abnormal heart rhythm that is associated with poor quality of life, substantial numbers of hospitalisations, increased risk of severe and potentially fatal cardiovascular complications such as stroke, as well as death.
Marking the start of World Heart Rhythm Week, the World Heart Federation (WHF), Atrial Fibrillation Association (AFA), Stroke Alliance For Europe (SAFE), and European Heart Rhythm Association (EHRA) have come together to call upon their peers around the world to raise awareness and understanding of AF and its cardiovascular consequences.
Atrial fibrillation (AF), is the most common cardiac arrhythmia (abnormal heart rhythm) seen by doctors. It is a fast growing public health concern currently affecting an estimated seven million people in the USA and Europe alone and it is expected to double by 2050, reflecting the growing proportion of elderly individuals.1,2 AF results from abnormal electrical activity in the upper chambers of the heart (atria), leading to an irregular heart rhythm which prevents the blood from efficiently being pumped toward the rest of the body1. Common symptoms of AF include palpitations (a rapid, irregular, "flopping" movement or pounding sensation in the chest), shortness of breath, dizziness and feeling of heaviness in the chest3.
"Patients with AF, have a substantially lower quality of life than healthy individuals as a result of their condition. If left untreated, they are at higher risk of experiencing stroke or other cardiovascular complications, which can have serious and debilitating consequences" said Trudie Lobban, CEO of the AFA.
"As AF carries a fivefold increase in the risk of stroke, the risk of death or severe morbidity is considerably increased as well. In addition patients who have a stroke and have AF often have a worse prognosis compared to patients without AF."
Age, obesity, hypertension, myocardial infarction (MI), congestive heart failure (CHF) and valvular heart diseases4 put patients at increased risk of developing AF and AF itself worsens the prognosis of patients with cardiovascular risk factors.4,5
"Very few people truly understand the real and significant impact of atrial fibrillation." Said Professor GĂ nter Breithardt, from the WHF "There is an urgent need for better information for patients. AF AWARE aims to expose the poor understanding of this complex disease and to help healthcare professionals, patients, policy makers and the general public understand that comprehensive management of AF should address its multiple impacts."
Results from an AF AWARE international survey of more than 1600 cardiologists and patients in 11 countries, confirm that patients need a better understanding of AF, its consequences and management options.
Despite the nature and risks of AF, [one in four] patients in this survey said he or she did not understand and could not explain what AF is and [only a third] were worried or fearful about having AF. Patients indiscriminately rated all risks of complications as high and confirmed the significant impact of AF on their quality of life and ability to conduct day to day activities.
Many patients in the survey preferred to receive information about AF from their cardiologists and primary care practitioners than from any other source. However, the majority of cardiologists ([61%]) in the survey said their patients needed more and better information on AF: they rated the quality of patient education materials for AF as inferior to that available for other common cardiovascular diseases, heart attack, hypertension, high cholesterol, diabetes and stroke.
"AF patients need much better information about their disease and doctors can play a central role in providing this help." Said Professor Vardas, president-elect of EHRA. "These results indicate that AF patients may feel resigned about living with this illness and its complications. World Heart Rhythm Week and AF AWARE are opportunities for us to come together to improve patients' experience of living with AF through awareness and education."
For the clinicians, the survey also showed that AF is a challenging disease to manage, placing increased strain on healthcare systems. Previous research has shown that AF represents one third of hospitalisations for arrhythmia1 and that 70 percent of the annual cost of AF management in Europe is driven by hospitalisation care and interventional procedures.6 In this survey, patients visited a doctor nearly nine times ([8.9 times]) a year for AF management.
A key concern highlighted in this survey was the average delay of [2.6] years between the onset of symptoms and diagnosis.
"These findings confirm the need for greater awareness and education about atrial fibrillation. It is a common condition and growing public health concern, with serious consequences for patients and their families. Early identification and treatment of AF could help to reduce the risk of serious cardiovascular complications associated with this disease" said [insert local spokesperson from AF AWARE]. "In order to address the full impact of the disease we call upon the medical profession and our peers to increase awareness of the disease and improve patient education."
AF AWARE's goals support broader initiatives for cardiovascular disease prevention such the recently-formed European Parliament's MEP Heart Group which brings together the European Heart Network and European Society of Cardiology.
AF AWARE is supported by an unrestricted educational grant from sanofi-aventis.
Atrial Fibrillation Association
Atrial Fibrillation Association (AFA) is a UK-registered charity which focuses on raising awareness of Atrial Fibrillation worldwide by providing information and support materials for patients and medical professionals involved in detecting, diagnosing and managing AF.
World Heart Federation
The mission of the World Heart Federation (WHF) is to help people achieve a longer and better life through prevention and control of heart disease and stroke, with a focus on low and middle income countries.
Stroke Alliance for Europe
The Stroke Alliance for Europe (SAFE) was formed October 2004 in Brussels and has a membership of 22 European Stroke Organisations. SAFE's vision is to work towards greatly decreasing the number of strokes in Europe and to ensure that all those who are touched by stroke get the help and support they need.
European Heart Rhythm Association
The European Heart Rhythm Association (EHRA) is an association specialising in electrophysiology and was created from the merger of two former Working Groups on 'Cardiac Pacing' and 'Arrhythmias'. Its ambition is to serve as the leading organisation in the field of arrhythmias and electrophysiology in Europe, and to attract all physicians from Europe and beyond to foster the development of this area of expertise.
AF AWARE Survey
The AF AWARE survey objective was to explore the differences and gaps in cardiologists' and patients' perceptions of atrial fibrillation (AF) by analysing perceptions of AF risks, patients' level of information, impact of AF and it's consequences on patients quality of life (QoL). The survey consisted of 810 cardiologists and 825 patients from 11 countries. Cardiologists arm: 96% of interviews were conducted online and the remainder by phone involving 24 questions (most using a 5-point scale). Patients arm: 43% of interviews were conducted online, 40% by phone and 17% face to face. Questionnaires to cardiologists explored their evaluation of risks associated with AF and its treatment, the type of communication/information given to patients, perceived levels of patient familiarity with AF, frequency/nature of consultations and level of patient satisfaction, QoL and health-economic impact of AF. The patient survey asked patients for an estimate/rate of risk of AF relative to other diseases, to describe their understanding of AF, define preferred sources of/satisfaction with AF information, describe the impact of AF on daily living.
1. Fuster V et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation. European Heart Journal 2006;27:1979-2030.
2. Go AS et al. JAMA 2001; 285: 2370-2375.
3. Benjamin/Circulation/Impact of AF on the Risk of death / P946 / Abstract / Lines A13-A14
4. Benjamin EJ et al. Prevention of atrial fibrillation: report from a national heart, lung, and blood institute workshop. Circulation 2009; 119(4): 606-618
5. Wachtell/JACC/Angiotensin II Receptor Blockade Reduces New-Onset AF/P716/Col 2/Paragraph 2/Lines 9-12
6. Ringborg A, et al. Costs of atrial fibrillation in five European countries: results from the Euro Heart Survey on atrial fibrillation. Europace. 2008 Apr;10(4):403-11. Epub 2008 Mar
European Heart Rhythm Association
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