A Call for Integrated Therapy
Patients often have both atrial fibrillation and heart failure, which are among the world’s most common conditions. Globally, 33 million people suffer from atrial fibrillation1 and 23 million from heart failure2; figures that are expected to increase. Both conditions are complex and thus extremely challenging to treat. Affected patients require personalized therapy.
“A lot goes in to treatment decisions, including managing heartrate and rhythm, assessing risks from medication and comorbidities, and genetic factors. Not all patients benefit equally from a single treatment approach,” explains Dr. Piorkowski. “It’s been a long time since atrial fibrillation and heart failure were seen as only affecting heart rhythm. Rather, they have complex symptoms and pose an increased risk of early mortality, stroke or repeat hospitalization.”
Numerous diagnostic and therapy options can treat atrial fibrillation and heart failure. “Giving patients the best treatment requires the various disciplines to work together and tailor their approach to individual patients,” notes Dr. Dietmar Bänsch, Clinic for Rhythmology and Electrophysiology in Güstrow, Germany.
The European Society of Cardiology’s 2016 update of its guidelines on atrial fibrillation is an indicator of the move towards interdisciplinary care. For the first time, the guidelines recommend that AF heart teams include specialists from different fields, such as cardiac surgeons and neurologists.3
Accurate Diagnostics and Continuous Monitoring are Essential to Personalized Therapy
Reliable diagnostics and monitoring that optimally detect pathophysiological heart characteristics and prognostic factors are a high priority in a tailored, interdisciplinary therapy strategy.
“There is great potential in new imaging techniques, such as MRI and 3D mapping systems, that combine anatomical and electrical information,” adds Dr. Bänsch. “Together with modern catheters, they make it possible for us to completely restore the heart’s anatomical structures and electrical activity, and to assess these factors individually. In turn, we can better understand complex interactions and perhaps even identify the cause of a rhythm disturbance.”
Cardiac rhythm monitoring is crucial to successful therapy. Clinically confirmed benefits have led the European treatment guidelines to include the continuous remote follow-up of patients with cardiac devices.4 Patients with an increased risk of sudden cardiac death or stroke of an unknown cause particularly benefit from the early detection of potentially life-threatening rhythms.
“The IN-TIME study demonstrated that daily remote patient follow-up with BIOTRONIK Home Monitoring® can reduce the mortality rate in heart failure patients by more than 50 percent. Comparing studies that used systems from other manufacturers, it is clear that the systems differ significantly. Only BIOTRONIK Home Monitoring demonstrates these positive effects,” comments Roberto Belke, Managing Director, BIOTRONIK Germany. “This is also due to our system’s reliable data transmission and the ensuing continuity in patient care.”
References:
1 Chugh S et al. Circulation. 2014, 129.
2 Roger V. Circ Res. 2013, 113.
3 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS.
4 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy. European Heart Journal. 2013, 34.