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December 04, 2023
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Top in cardiology: New atrial fibrillation guideline; exercise and cardiovascular risk

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The American College of Cardiology and the American Heart Association have updated their atrial fibrillation guideline to highlight early rhythm control and prevention strategies.

The guideline proposes a new classification system that uses stages to recognize atrial fibrillation (AF) as a progressive disease, requiring different strategies at different stages.

Guidelines_Adobe Stock
The American College of Cardiology and the American Heart Association have updated their atrial fibrillation guideline to highlight early rhythm control and prevention strategies. Image source: Adobe Stock

“What we wanted to emphasize with this new staging system is that AF is a complex disease that requires understanding,” Jose Joglar, MD, FAHA, the Elizabeth Thaxton and Ellis Batten Page Professor in Cardiac Electrophysiology Research, and director of the clinical cardiac electrophysiology fellowship program at UT Southwestern Medical Center in Dallas, and chair of the writing committee, told Healio. “It requires a multidisciplinary approach. We need to approach AF in a more holistic way, from prevention to screening and then intervention.”

The new guideline also includes updated recommendations for catheter ablation, as well as lifestyle and risk factor modification. It was the top story in cardiology last week.

In another top story, a review published in the Journal of Cardiovascular Development and Disease evaluated the relationship between physical activity and atrial fibrillation.

While lower levels of exercise decrease the risk for death and heart disease, some studies have shown that certain types of intense exercise may increase the risk for AF.

“A select population that consistently engages in high-intensity endurance activity, such as elite or ultra-endurance athletes, should be aware of the potential increased risk for AF at prolonged intense levels of activity,” according to Mattia Petrungaro, MD, and colleagues, the authors of the review.

Read these and more top stories in cardiology below:

New atrial fibrillation guideline highlights early rhythm control, prevention strategies

An updated guideline on the prevention and management of AF includes a new staging system to emphasize disease progression, along with updated recommendations for catheter ablation and left atrial appendage occlusion. Read more.

Physical activity and atrial fibrillation: Where’s the balance?

Atrial fibrillation is a common arrhythmia that increases risk for stroke, heart failure and dementia. Although AF risk increases with age, it can also occur in young people with normal hearts, sometimes called “lone AF.” Read more.

Two post-approval outcome trials of anti-hyperkalemia drug stopped for logistical reasons

AstraZeneca announced that two post-approval randomized heart- and kidney-related outcome studies of its anti-hyperkalemia drug have been stopped due to slow enrollment and low event rates. Read more.

Early-onset heart disease drives risk for Alzheimer's disease, other dementias

Adults with a diagnosis of coronary heart disease before age 45 years are 36% more likely to develop dementia over 13 years of follow-up compared with those without a coronary heart disease diagnosis, data from the UK Biobank show. Read more.

TRANSFORM trial will harness AI to evaluate personalized heart disease care strategies

A randomized controlled trial will assess whether pairing coronary CT angiography with an investigational AI algorithm to stage coronary plaque burden is superior to usual care for primary prevention of cardiovascular events. Read more.