Atrial fibrillation and AF‑related stroke

Atrial fibrillation (AF) is a common condition and leading cause of stroke, yet is widely under-recognised and people across Europe face significant inequalities in access to detection and treatment. 

Atrial fibrillation and AF‑related stroke

Atrial fibrillation (AF) is a common condition and leading cause of stroke, yet is widely under-recognised and people across Europe face significant inequalities in access to detection and treatment. 

Context

Atrial fibrillation (AF) is the most common sustained heart rhythm disturbance (arrhythmia), making people with AF three to five times more likely to suffer a debilitating, disabling and often fatal stroke.

AF-related strokes cause more severe symptoms, have a higher chance of recurrence and lead to more permanent disability than non-AF-related strokes. They are also more expensive for healthcare systems to manage.

As our populations age, the scale of the problem is increasing. A quarter of middle-aged adults will develop AF in their lifetime, and it is estimated that almost 18 million Europeans over 55 will have AF by 2060.

With early detection, access to appropriate therapies and ongoing care and support, many AF-related strokes can be prevented. But many people in Europe face inequalities and unmet needs in AF-related stroke. There is an urgent need to improve detection and ensure best practice is delivered across all settings, to improve the lives of people with AF and contribute to the sustainability of our healthcare systems.

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Up to 45% of people with AF remain undetected, depending on the setting

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Stroke was responsible for 9% of deaths in Europe in 2013

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By 2035, the number of strokes in Europe is projected to rise by 34%

What we achieved

HPP worked with a group of expert advisors from across Europe to develop the White Paper on inequalities and unmet needs in the detection of atrial fibrillation (AF) and use of therapies to prevent AF‑related stroke in Europe.

In November 2018, the white paper was launched online and at an event at the UK Parliament. The All-Party Parliamentary Group on Atrial Fibrillation meeting was held as part of Global AF Aware Week, and the report was presented by Trudie Lobban MBE, Founder and CEO of the AF Association and Arrhythmia Alliance, who was one of the expert advisors on the project.

The white paper was the culmination of several months’ work including an advocacy summit at which the advisory board reached consensus on the key issues around inequalities and unmet needs in AF-related stroke. HPP also developed a communications toolkit to help stakeholders disseminate the white paper and its key messages.

This project is a continuation of HPP’s previous work in this area, the Route Map for Change & the European Atlas on the Prevention of AF-Related Stroke.

‘HPP has been an invaluable partner to our patient advocacy work, and also many of our partners across Europe. Through their research and collaboration, they have opened up many new opportunities for campaigning at both national and international level. They know how to make it relevant and impactful throughout, how to integrate different views, and grow a wider alliance as a result. It’s been a very powerful combination and we have much to show for it. Always professional and delivers on time. A great team to work with.’

Trudie C A Lobban MBE FRCP (Edin)

Founder and CEO, AF Association & Arrhythmia Alliance

Key partners and stakeholders

Lead expert advisor

  • Professor John Camm, Professor of Clinical Cardiology, St George’s University Hospitals, London; President, European Heart Rhythm Association; President and Trustee, Arrhythmia Alliance; Founder and Trustee, Atrial Fibrillation Association

Expert advisors

  • Sotiris Antoniou, Chair, International Pharmacist Anticoagulation Taskforce (iPACT) and Consultant Pharmacist, Barts Health NHS Trust; member of AF Association Medical Advisory Committee
  • Professor Anita Arsovska, President, Macedonian Society of Neurology; University Clinic of Neurology, Skopje, Macedonia
  • Professor Valeria Caso, Past President, European Stroke Organisation (ESO); Stroke Neurologist, University of Perugia Stroke Unit

 
 

  • Dr Wolfram Doehner, Chair, European Society of Cardiology Council on Stroke; Charité Universitätsmedizin Berlin
  • Jean-Luc Eiselé, Chief Executive Officer, World Heart Federation
  • Dr Johan Engdahl, Adjunct Senior Lecturer, Danderyd University Hospital, Karolinska Institutet
  • Sue Koob, CEO, Preventive Cardiovascular Nurses Association
  • Trudie Lobban MBE, Founder and CEO, Atrial Fibrillation Association and Arrhythmia Alliance
  • Professor Lis Neubeck, Head of Cardiovascular Health, Edinburgh Napier University; President Elect, ESC Association of Cardiovascular Nursing and Allied Professions; member of AF Association Medical Advisory Committee
  • Professor Marten Rosenqvist, Professor of Heart Diseases and Senior Consultant, Danderyd University Hospital, Karolinska Institutet
  • Dr Geert Vanhooren, Head of Department (Neurology), AZ Sint-Jan Brugge Oostende AV, Ostend

The following organisations have endorsed the white paper:

Arrhythmia Alliance; AF Association; International Pharmacists for Anticoagulation Care Taskforce (iPACT); Macedonian Neurology Society; Macedonian Stroke Association; Preventive Cardiovascular Nurses Association; Stroke Alliance for Europe; Stroke Association; World Heart Federation

The project was initiated and funded by the BMS–Pfizer Alliance.