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Progress toward the prevention and treatment of atrial fibrillation: A summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9–10, 2013

Published:November 17, 2014DOI:https://doi.org/10.1016/j.hrthm.2014.11.011
      The Heart Rhythm Society convened a research symposium on December 9–10, 2013, in Washington, DC, that focused on the prevention of atrial fibrillation (AF) as well as AF-related stroke and morbidity. Attendees sought to summarize advances in understanding AF since a 2008 National Institutes of Health (NIH) conference on this topic
      • Benjamin E.J.
      • Chen P.S.
      • Bild D.E.
      • et al.
      Prevention of atrial fibrillation: report from a national heart, lung, and blood institute workshop.
      and to identify continued knowledge gaps and current research priorities. The research symposium also sought to identify key deficiencies and opportunities in research infrastructure, operations, and methodologies. The committee sought to identify both basic research targets and how clinical AF research could be improved in the current health care environment. This whitepaper summarizes our deliberations in an effort to accelerate progress toward preventing AF and its consequences. Although largely focused on primary prevention of AF, the paper also addresses some aspects of secondary prevention of recurrent AF due to the continuum of risk factors that contribute to arrhythmogenesis, permissive left atrial (LA) substrates, and the emergence of AF.

      Abbreviations:

      ACEi (angiotensin-converting enzyme inhibitor), AF (atrial fibrillation), A-II (angiotensin-II), ANP (atrial natriuretic peptide), ARB (angiotensin receptor blocker), BP (blood pressure), BMI (body mass index), BNP (brain natriuretic peptide), CaMKII (calmodulin-dependent kinase II), DAD (delayed afterdepolarization), EAD (early afterdepolarization), ECM (electrocardiographic mapping), EHR (electronic health record), ET-1 (endothelin-1), GGA (geranyl-geranylacetone), GP (ganglionated plexi), HDAC6 (histone deacetylase-6), HF (heart failure), HSP (heat shock protein), LA (left atrium), LAA (left atrial appendage), LGE-CMR (late gadolinium enhanced cardiac magnetic resonance imaging), LV (left ventricle), MRI (magnetic resonance imaging), NIH (National Institutes of Health), NOAC (non–vitamin K-dependent oral anticoagulant), NP (natriuretic peptide), OAC (oral anticoagulant), PAC (premature atrial contraction), pAF (paroxysmal atrial fibrillation), PV (pulmonary vein), PVI (pulmonary vein isolation), RAAS (renin–angiotensin–aldosterone system), RCT (randomized controlled trial), RSD (renal sympathetic denervation), SDB (sleep disordered breathing), SR (sarcoplasmic reticulum), TGF (transforming growth factor), TTR (time in therapeutic range)
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