A roadmap to improve the quality of atrial fibrillation management:proceedings from the fifth Atrial Fibrillation Network/European Heart Rhythm Association consensus conference

At least 30 million people worldwide carry a diagnosis of atrial fibrillation (AF), and many more suffer from undiagnosed, subclinical, or 'silent' AF. Atrial fibrillation-related cardiovascular mortality and morbidity, including cardiovascular deaths, heart failure, stroke, and hospitalizations, remain unacceptably high, even when evidence-based therapies such as anticoagulation and rate control are used. Furthermore, it is still necessary to define how best to prevent AF, largely due to a lack of clinical measures that would allow identification of treatable causes of AF in any given patient. Hence, there are important unmet clinical and research needs in the evaluation and management of AF patients. The ensuing needs and opportunities for improving the quality of AF care were discussed during the fifth Atrial Fibrillation Network/European Heart Rhythm Association consensus conference in Nice, France, on 22 and 23 January 2015. Here, we report the outcome of this conference, with a focus on (i) learning from our 'neighbours' to improve AF care, (ii) patient-centred approaches to AF management, (iii) structured care of AF patients, (iv) improving the quality of AF treatment, and (v) personalization of AF management. This report ends with a list of priorities for research in AF patients

Sauvages dans la Ville

La deuxième Année Européenne pour la Conservation de la Nature attirait l\u27attention de l\u27opinion publique et des décideurs sur l\u27existence et la valeur d\u27une nature ordinaire, hors des espaces protégés. Sauvages dans la ville apporte une réponse concrète à cet appel, sous la forme d\u27un hommage au naturaliste Paul JOVET. Il se passionnait pour la flore triviale des terrains vagues et pour le cortège des plantes qui accompagnent les migrations des hommes : c\u27était un précurseur. La ville et son patrimoine biologique ne sont pas seulement un sujet d\u27études, mais aussi un objet d\u27expérimentation culturelle et sociale. Au-delà de la richesse des contributions scientifiques et techniques, le colloque Paul JOVET, organisé au Muséum National d\u27Histoire Naturelle, faisait une large place aux témoignages et à l\u27expérience d\u27associations et d\u27enseignants. Habité par une généreuse curiosité, Paul JOVET aimait Paris et sa banlieue, s\u27impliquait pour y préserver les espaces de nature et les interstices herbeux. Une position de recherche restituée ici par les témoignages de ses contemporains et de ses disciples, en correspondance avec les préoccupations actuelles pour une ville durable, plus réceptive à la nature.Une ville plus humaine. </p

Expert consensus document: Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care