Authors
Svennberg E, Merino JL, Andrade J, Anselmino M, Arbelo E, Boersma E, Boriani G, Breithardt G, Chung M, Chyou J, Cohen A, Nielsen JC, Dichtl W, Diederichsen SZ, Dobrev D, Doehner W, Dworatzek E, Fabritz L, Filgueiras-Rama D, Gimpelewitz C, Hack G, Hatem S, Healey J, Heidbuchel H, Hijazi Z, Holst AG, Hove-Madsen L, Jalife J, van Leerdam R, Linz D, Lip GYH, Lubitz S, de Melis M, Meyer R, Orczykowski M, Parwani AS, Porta-Sanchez A, de Potter T, Ravens U, Rienstra M, Rillig A, Rivard L, Scherr D, Schnabel RB, Schotten U, Simovic S, Sinner M, Sohns C, Sommer P, Steinbeck G, Steven D, Sultan A, Thomalla G, Toennis T, Tzeis S, Voigt N, Wadhwa M, Wakili R, Witt H, Goette A, Kirchhof P
Journal
Europace
Citation
Europace. 2025 Dec 15:euaf318.
Abstract
Atrial fibrillation (AF) is a growing unmet medical need. To reduce its impact on patients´ lives, improvements in stroke prevention therapy, treatment of concomitant conditions, and rhythm control therapy are actively developed: Innovations in antithrombotic agents, new antiarrhythmic drugs, and novel interventional rhythm control therapies emerge alongside AF-reducing effects of general cardiometabolic therapies. Simple risk scores are slowly replaced by personalised AF risk estimation using quantifiable features. These developments were discussed by over 80 experts from academia and industry during the 10th AFNET/EHRA consensus conference from 5-7 May 2025. The emerging consensus, described here, is multi-domain therapy combining stroke prevention, rhythm control, and therapy of concomitant cardiovascular conditions. This combines anticoagulants, antiarrhythmic drugs and AF ablation with old and new cardiometabolic drugs that can reduce AF risk, AF burden and AF-related complications at scale. The paper furthermore describes quantitative traits that may enable a shift toward risk-driven therapy based on AF phenotypes. These can enable adjusted therapy strategies that are safe, accessible, and patient-centred. Applying modern data science and artificial intelligence methods to quantitative phenotypic and genetic features can further improve risk estimation and personalized therapy selection. At the same time, translational and clinical research into reversing the drivers of AF and into improved stroke prevention through new drugs and through combination therapies is needed. Together, these efforts offer pathways towards personalized, patient-centred, multimodal and accessible AF management that integrates rhythm control, stroke prevention, and therapy of concomitant conditions to bridge today’s practical needs with tomorrow’s therapeutic innovation.
