Smarter strategies to treat atrial fibrillation
An innovative smartphone app developed in an EU-funded project is helping doctors provide thousands of heart patients across Europe with better, more personalised treatment for atrial fibrillation - a major cause of stroke, dementia, heart failure and premature death.
© Maryne RENON, 2018
Atrial fibrillation is the most common type of irregular heartbeat, or cardiac arrhythmia, affecting 2-3 % of the European population and as many as one in 10 people over the age of 80. Its prevalence is expected to double or triple in the next few decades as the population ages, significantly increasing the burden on healthcare systems.
The EU-funded CATCH ME project is addressing that challenge by providing innovative digital tools to enhance clinical practice, and by conducting groundbreaking research into the mechanisms and effects of atrial fibrillation in order to improve treatment.
Were helping patients to take ownership of managing the disease, and enabling both healthcare professionals and patients to make informed decisions based on the best available scientific evidence, says project coordinator Paulus Kirchhof at the University of Birmingham in the UK.
A smartphone revolution in clinical decision-making
To support the implementation of this approach in practice, CATCH ME tools are included in the European Society of Cardiology (ESC)s Pocket Guidelines app. By inputting patient data and integrating the system with clinical diagnostic tools, the app enables healthcare professionals to easily and quickly obtain guidelines and decide treatment pathways based on optimised therapy approaches, drawing on up-to-date knowledge about the mechanisms of atrial fibrillation in specific patient groups.
According to the ESC, the tool is revolutionising everyday clinical decision-making and patient follow-up, enabling accurate and swift diagnosis and treatment choices in line with best-practice guidelines. Thousands of doctors across Europe are already using it.
Our work has the potential to better guide the effective use of existing treatments for patients with atrial fibrillation, Kirchhof says. Longer term, the main goal of the CATCH ME consortium is to build a classification system to identify why each patient develops atrial fibrillation.
Using modern tools and techniques to identify the molecular changes that occur as a consequence of atrial fibrillation in heart tissue samples, the CATCH ME team has identified several novel biomarkers that could serve as early-warning signs of the disease.
Currently being validated against large independent clinical datasets, these biomarkers could be used for patient screening, for developing novel tools to identify heartbeat irregularities and to guide treatment approaches based on the concept of stratified therapy.
From scientific knowledge to clinical practice
Stratified therapy offers a more personalised form of care in which treatments are prescribed based on the distinct mechanisms by which a particular disease affects some groups of patients or how patients respond to particular treatments. This differs from current treatment approaches which fail to harness up-to-date scientific knowledge about the mechanisms of atrial fibrillation. With the exception of the use of anti-coagulation medication to prevent atrial fibrillation-related blood clots and strokes, current preventive care is often ineffective and treatment strategies are not having a significant impact on patient outcomes.
CATCH ME is bridging the disconnect between our understanding of the molecular and electrophysiological mechanisms of atrial fibrillation and the current unstructured approach to its prevention and treatment, Kirchhof says. Atrial fibrillation classification and the application of stratified therapy will enable doctors to select the right treatments for specific patients, avoiding futile treatment attempts and reducing complications.
Studies aimed at building the atrial fibrillation classification are being performed on individuals recruited throughout Europe by the CATCH ME partners. With a large sample size and diverse patients, the aim is to ensure the classification is comprehensive and representative of the real population of patients with the condition.
We expect this classification will be clinically useful for all healthcare providers, and for it to be adopted by the most important scientific and medical organisations involved in atrial fibrillation therapy, Kirchhof says.