Evidence map›Paper›PMID 40073206›Full record

GuidelineEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association.

Wolfram Doehner, Giuseppe Boriani, Tatjana Potpara, Carina Blomstrom-Lundqvist, Rod Passman, Luciano A Sposato, Dobromir Dobrev, Ben Freedman, Isabelle C Van Gelder, Taya V Glotzer and 11 more

Abstract readPractice GuidelineReviewConsensus Statement
In one paragraph

Guideline in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Alcohol consumption and risk of atrial fibrillation: a pairwise and network meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Pooled it
  2. Key stakeholder views on atrial fibrillation screening: a systematic mixed-studies review and interpretive analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Pooled it
  3. Incident heart failure in patients with screening-detected atrial fibrillation: a post hoc analysis of the STROKESTOP and STROKESTOP II studies.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  4. Digital recruitment and prevalence of screen-detected atrial fibrillation in nationwide patch-based ECG screening: the NORSCREEN randomized clinical trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  5. Early recurrence of atrial tachyarrhythmia after catheter ablation and its associations with clinical outcomes, atrial fibrillation burden, and blanking period duration: a post hoc analysis of the CABANA trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  6. Trial
  7. Inflammation and day-to-day occurrence of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Trial
  8. Trial
  9. Trial
  10. Personalized pulmonary vein isolation guided by left atrial wall thickness for persistent atrial fibrillation ablation: the PeAF-by-LAWT randomized trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Trial
  11. Recent highlights from theInternational journal of cardiology. Heart & vasculature · 2026
    Article
  12. Review
  13. Identifying patients at low risk for atrial fibrillation after cryptogenic stroke: the PAVA score.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Observational
  14. Wearable smartwatches for atrial fibrillation detection and burden estimation after ablation: comparison with continuous monitoring.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  15. Minimized atrial pacing and atrial fibrillation burden in the DANPACE II trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  16. Association of the EHRA/HRS/APHRS/LHRS definition of atrial cardiomyopathy with incident atrial fibrillation, heart failure, and stroke.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  17. Article
  18. Review
  19. Article
  20. Article

17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Wolfram DoehnerBerlin Institute of Health Center for Regenerative Therapies, Charité -Universitätsmedizin Berlin, Föhrerstr. 15, Berlin 13353, Germany.ORCID 0000-0001-7598-708X
Giuseppe BorianiDivision of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.ORCID 0000-0002-9820-4815
Tatjana PotparaMedical Faculty, University of Belgrade, Dr Subotica 13, 11000 Belgrade, Serbia.ORCID 0000-0001-6285-6902
Carina Blomstrom-LundqvistDepartment of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID 0000-0003-2806-3903
Rod PassmanDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID 0000-0001-8718-1534
Luciano A SposatoDepartment of Clinical Neurological Sciences and Brain & Heart Lab, Western University, London, Ontario, Canada.ORCID 0000-0001-6425-9343
Dobromir DobrevInstitute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany.ORCID 0000-0002-4612-117X
Ben FreedmanHeart Research Institute, Sydney Medical School, Charles Perkins Centre, and Department of Cardiology, Concord Hospital, The University of Sydney, Sydney, Australia.ORCID 0000-0002-3809-2911
Isabelle C Van GelderUniversity of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0002-7579-1201
Taya V GlotzerDivision of Cardiac Electrophysiology, Hackensack University Medical Center, Hackensack, NJ 07601, USA.ORCID 0000-0001-5286-2612
Jeff S HealeyPopulation Health Research Institute, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-1216-7580
Theodore Karapanayiotides2nd Department of Neurology, Aristotle University of Thessaloniki, School of Medicine, AHEPA University Hospital, Thessaloniki, Greece.ORCID 0000-0002-2357-7967
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.ORCID 0000-0002-7566-1626
Jose Luis MerinoArrhythmia and Robotic Electrophysiology Unit, La Paz University Hospital-IdiPaz, Autonoma University, Madrid, Spain.ORCID 0000-0002-1737-1903
George Ntaios1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.ORCID 0000-0002-0629-9248
Renate B SchnabelDepartment of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID 0000-0001-7170-9509
Jesper H SvendsenDepartment of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.ORCID 0000-0001-8466-8515
Emma SvennbergDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.ORCID 0000-0002-6413-0870
Rolf WachterDepartment of Cardiology, University Hospital Leipzig, Leipzig, Germany.ORCID 0000-0003-2231-2200
Karl Georg HaeuslerDepartment of Neurology, Universitätsklinikum Ulm, Ulm, Germany.ORCID 0000-0002-6389-5054
A John CammClinical Cardiac Academic Group, Genetic and Cardiovascular Sciences Institute, City-St George's University of London, London, UK.ORCID 0000-0002-2536-2871

Funding

BayerBoston ScientificDaiichi SankyoMedtronicSanofi
6 · The paper itself

Abstract

Atrial fibrillation (AF) is one of the most common cardiac diseases and a complicating comorbidity for multiple associated diseases. Many clinical decisions regarding AF are currently based on the binary recognition of AF being present or absent with the categorical appraisal of AF as continued or intermittent. Assessment of AF in clinical trials is largely limited to the time to (first) detection of an AF episode. Substantial evidence shows, however, that the quantitative characteristic of intermittent AF has a relevant impact on symptoms, onset, and progression of AF and AF-related outcomes, including mortality. Atrial fibrillation burden is increasingly recognized as a suitable quantitative measure of intermittent AF that provides an estimate of risk attributable to AF, the efficacy of antiarrhythmic treatment, and the need for oral anticoagulation. However, the diversity of assessment methods and the lack of a consistent definition of AF burden prevent a wider clinical applicability and validation of actionable thresholds of AF burden. To facilitate progress in this field, the AF burden Consensus Group, an international and multidisciplinary collaboration, proposes a unified definition of AF burden. Based on current evidence and using a modified Delphi technique, consensus statements were attained on the four main areas describing AF burden: Defining the characteristics of AF burden, the recording principles, the clinical relevance in major clinical conditions, and implementation as an outcome in the clinic and in clinical trials. According to this consensus, AF burden is defined as the proportion of time spent in AF expressed as a percentage of the recording time, undertaken during a specified monitoring duration. A pivotal requirement for validity and comparability of AF burden assessment is a continuous or near-continuous duration of monitoring that needs to be reported together with the AF burden assessment. This proposed unified definition of AF burden applies independent of comorbidities and outcomes. However, the disease-specific actionable thresholds of AF burden need to be defined according to the targeted clinical outcomes in specific populations. The duration of the longest episode of uninterrupted AF expressed as a time duration should also be reported when appropriate. A unified definition of AF burden will allow for comparability of clinical study data to expand evidence and to establish actionable thresholds of AF burden in various clinical conditions. This proposed definition of AF burden will support risk evaluation and clinical treatment decisions in AF-related disease. It will further promote the development of clinical trials studying the clinical relevance of intermittent AF. A unified approach on AF burden will finally inform the technology development of heart rhythm monitoring towards validated technology to meet clinical needs.

Indexed as

Atrial FibrillationCardiologyStrokeAnti-Arrhythmia AgentsConsensusCost of IllnessEuropeHumansRisk AssessmentRisk FactorsAnti-Arrhythmia AgentsAF burdenAtrial fibrillationClinical outcomeECG monitoringHeart failureMortalityQuality of lifeStroke

Identifiers

PMID40073206
PMCPMC11901050

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.