The month of September is Atrial Fibrillation (AFib) Awareness Month. AFib is the most common arrhythmia in clinical practice affecting more than 2.2 million people in the U.S. and 4.5 million people in the European Union. As a result it is also an extremely costly public health problem, with roughly $3,600 as the global annual cost per patient.

Over the last 20 years there has been a 66 percent increase in hospital admissions for AFib. Some of the reasons for this increase include an aging population; increasing prevalence of chronic heart disease; and more frequent diagnosis thanks to improving technology. The rising obesity epidemic is also no doubt another factor.

As part of AFib Awareness Month, the College is focused on raising awareness about AFib among both clinicians and patients. According to the ACC/AHA AFib Guidelines, it’s very important that an overall management strategy be discussed with patients. This strategy should incorporate: •    type and duration of AFib •    associated symptoms •    associated cardiovascular disease •    effect of age and other medical conditions •    cardiovascular risks of AFib •    short-term and long-term treatment goals •    pharmacological and nonpharmacological therapeutic options

Treatment options for patients at risk of stroke include anticoagulation of any type (vitamin K antagonist, direct thrombin inhibitors, Xa inhibitors) as indicated by guidelines, and their risks, side effects and benefits. There are now several options that are highly efficacious in reducing the risk of stroke. Several clinical trial updates recently addressed topics such as stroke rates in patients presenting to the emergency room with AFib and the impact on renal function of apixaban vs. warfarin in AFib patients. The WOEST trial at ESC, was the first randomized trial comparing clopidrogel with and without aspirin in patients on oral anticoagulant therapy who were undergoing PCI.

Unfortunately, there is still significant clinical underuse of anticoagulant therapies in AFib and misunderstandings about the safety and efficacy of novel anticoagulant agents. Furthermore, a recent CardioSurve survey found several key differences in the treatment of AFib around the globe. Cardiologists were surveyed from the US, Brazil, China, Germany, India and the UK, and showed that control over anticoagulation options varied by country. Physicians in the UK and China indicate that they have less control over the anticoagulation options available to patients. Costs and bleeding rate concerns are among the reasons for the difference. The College is currently in the early stages of developing a comprehensive initiative to address gaps in treatment and encourage compliance with guideline-recommended care.

On the patient front, CardioSmart offers patients tools to support them in their treatment and management of AFib. The AFib condition center on CardioSmart.org has background of the disease, the key facts, questions to ask a doctor and more. In addition, patient education videos include What You Need to Know About Stroke Risk and Why Your Rate and Rhythm Matter. Check out our “AF by the Numbers” infograph on CardioSmart’s Facebook page  and share with your patients.

This week the College launched its new AFib Clinical Toolkit, which provides tools and strategies for the patient care team to support high-quality care for patients with AFib in light of new therapies.

More on the AFib toolkit and other efforts by the College to continuously educate health care providers on the tried-and-true practices for AFib care through innovative educational programs will be discussed in the coming weeks here on the blog, so stay tuned!

This blog post is part of a series of blog posts during AFib Awareness Month. Stay tuned in the coming weeks for more information from the College on AFib news, tools and initiatives. Also visit ACC’s Facebook page for additional information.

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