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An international cardiology working group has published a consensus report on atrial cardiomyopathy (1). 21 scientists from the rhythmological societies of Europe (European Heart Rhythm Association (EHRA)), North America (Heart Rhythm Society (HRS)), South America (Latin American Heart Rhythm Society (LAHRS)) and the Asia-Pacific region (Asia Pacific Heart Rhythm Society APHRS) were involved. The expert group was led by AFNET board member Prof. Andreas Goette, Paderborn, Germany. He presented the results on August 31, 2024 at the annual congress of the European Society of Cardiology (ESC) in London.
Atrial cardiomyopathy (AtCM) refers to pathological changes in the heart's atria, including the atrial muscle cells. They contribute to the development of atrial fibrillation, can cause blood clots and strokes and are therefore of fundamental clinical importance.
The consensus document developed by the international group of experts within two years summarizes the current knowledge on atrial cardiomyopathy – from basic pathophysiological research to innovative imaging and diagnostic procedures to recommendations for therapy. It is already the second global consensus paper on atrial cardiomyopathy. In 2016, an international group of experts met for the first time on this topic and proposed a standardized definition and classification scheme for atrial cardiomyopathies (2).
Prof. Goette, who also headed the working group at that time, explained the background of the expert consensus: “Our aim is to further improve the prevention and treatment of atrial fibrillation. Atrial fibrillation has many different causes. It is therefore important to describe the underlying pathology and develop tailored therapies for atrial fibrillation based on the actual causes. The classification enables individualized therapy that offers patients the best possible treatment success.”
Since the first global consensus document eight years ago, research in the field of atrial cardiomyopathy has made considerable progress. Prof. Goette summarizes the key findings of the current consensus document, to which AFNET board member Prof. Ulrich Schotten, Maastricht, NL, also made a significant contribution: “There is a scientific update to the previous document from 2016. For the first time, we have introduced a clinically applicable grading of atrial cardiomyopathy with three stages (stage 1, 2 and 3) as a consensus. Imaging has also been presented in great detail in order to detect atrial pathologies non-invasively.”
However, there are still numerous knowledge gaps that need to be filled in the future. The experts therefore also made recommendations for future studies in the consensus paper.
The international consensus document was drawn up in collaboration with the European research consortium MAESTRIA. Prof. Dobromir Dobrev, Essen, Germany, Prof. Stéphane Hatem and Dr. Laurie Soulat-Dafour, both Paris, France, from the MAESTRIA consortium were involved.
References
(1) Goette A, Corradi D, Dobrev D, Aguinaga L, Cabrera JA, Chugh SS, de Groot JR, Soulat-Dufour L, Fenelon G, Hatem SN, Jalife J, Lin YJ, Lip GYH, Marcus GM, Murray KT, Pak HN, Schotten U, Takahashi N, Yamaguchi T, Zoghbi WA, Nattel S. Atrial Cardiomyopathy Revisited - Evolution of a Concept. A Clinical Consensus Statement of the 1 European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian 2 Pacific Heart Rhythm Association (APHRS), and the Latin American Heart Rhythm Society (LAHRS). Europace. 2024 Jul 30. DOI: 10.1093/europace/euae204
(2) Goette A, Kalman JM, Aguinaga L, Akar J, Cabrera JA, Chen SA, et al. EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication. Europace. 2016;18(10):1455-90. DOI: 10.1093/europace/euw161
About the Atrial Fibrillation NETwork (AFNET)
The Atrial Fibrillation NETwork is an interdisciplinary research network comprising scientists and physicians from hospitals and practices dedicated to improving the management of atrial fibrillation through coordinated research in Germany, Europe, and worldwide. Its main objective is to conduct high quality investigator-initiated clinical trials and registries on a national and international level as well as translational research projects. The AFNET continues the long-term activities of the network which has been funded by the German Federal Ministry of Research and Education over a decade. Since January 2015, specific projects and infrastructures of the AFNET are funded by the German Centre for Cardiovascular Research (DZHK), and some projects by EU research grants. AFNET has long expertise in the management of atrial fibrillation, but also provides support for work in other fields informing cardiovascular care. The results of 20 years of clinical and translational research improved the lives of patients with cardiovascular diseases and influenced treatment guidelines.
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Goette A et al. Atrial Cardiomyopathy Revisited - Evolution of a Concept. A Clinical Consensus Statement of the 1 European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian 2 Pacific Heart Rhythm Association (APHRS), and the Latin American Heart Rhythm Society (LAHRS). Europace. 2024 Jul 30. DOI: 10.1093/europace/euae204
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