TY - JOUR
T1 - Antithrombotic Therapy in Atrial Fibrillation Associated with Valvular Heart Disease: Executive Summary of a Joint Consensus Document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, Endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE)
AU - Lip, Gregory Y. H.
AU - Collet, Jean Philippe
AU - De Caterina, Raffaele
AU - Fauchier, Laurent
AU - Lane, Deirdre A.
AU - Larsen, Torben B.
AU - Marin, Francisco
AU - Morais, Joao
AU - Narasimhan, Calambur
AU - Olshansky, Brian
AU - Pierard, Luc
AU - Potpara, Tatjana
AU - Sarrafzadegan, Nizal
AU - Sliwa, Karen
AU - Varela, Gonzalo
AU - Vilahur, Gemma
AU - Weiss, Thomas
AU - Boriani, Giuseppe
AU - Rocca, Bianca
PY - 2017
Y1 - 2017
N2 - Management strategies for patients with atrial fibrillation (AF) in association with
valvular heart disease (VHD) have been less informed by randomized trials, which have
largely focused on ‘non-valvular AF’ patients. Thromboembolic risk also varies according
to valve lesion and may also be associated with CHA2DS2-VASc score risk factor
components, rather than only the valve disease being causal.
Given the need to provide expert recommendations for professionals participating in
the care of patients presenting with AF and associated VHD, a task force was convened
by the European Heart Rhythm Association (EHRA) and European Society of Cardiology
(ESC) Working Group (WG) on Thrombosis, with representation from the ESC WG on
Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society
(APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de
Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively
review the published evidence, and to produce a consensus document on the
management of patients with AF and associated VHD, with up-to-date consensus
statements for clinical practice for different forms of VHD, based on the principles of
evidence-based medicine.
This is an executive summary of a consensus document which proposes that the term
‘valvular AF’ is outdated and given that any definition ultimately relates to the evaluated
practical use of oral anticoagulation (OAC) type, we propose a functional EHRA
(Evaluated Heartvalves, Rheumatic or Artificial) categorization in relation to the type
of OAC use in patients with AF, as follows: (1) EHRA (Evaluated Heartvalves, Rheumatic
or Artificial) type 1 VHD, which refers to AF patients with ‘VHD needing therapy with a
vitamin K antagonist (VKA)’ and (2) EHRA (Evaluated Heartvalves, Rheumatic or
Artificial) type 2 VHD, which refers to AF patients with ‘VHD needing therapy with a
VKA or a non-VKA oral anticoagulant also taking into consideration CHA2DS2-VASc
score risk factor components.
AB - Management strategies for patients with atrial fibrillation (AF) in association with
valvular heart disease (VHD) have been less informed by randomized trials, which have
largely focused on ‘non-valvular AF’ patients. Thromboembolic risk also varies according
to valve lesion and may also be associated with CHA2DS2-VASc score risk factor
components, rather than only the valve disease being causal.
Given the need to provide expert recommendations for professionals participating in
the care of patients presenting with AF and associated VHD, a task force was convened
by the European Heart Rhythm Association (EHRA) and European Society of Cardiology
(ESC) Working Group (WG) on Thrombosis, with representation from the ESC WG on
Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society
(APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de
Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively
review the published evidence, and to produce a consensus document on the
management of patients with AF and associated VHD, with up-to-date consensus
statements for clinical practice for different forms of VHD, based on the principles of
evidence-based medicine.
This is an executive summary of a consensus document which proposes that the term
‘valvular AF’ is outdated and given that any definition ultimately relates to the evaluated
practical use of oral anticoagulation (OAC) type, we propose a functional EHRA
(Evaluated Heartvalves, Rheumatic or Artificial) categorization in relation to the type
of OAC use in patients with AF, as follows: (1) EHRA (Evaluated Heartvalves, Rheumatic
or Artificial) type 1 VHD, which refers to AF patients with ‘VHD needing therapy with a
vitamin K antagonist (VKA)’ and (2) EHRA (Evaluated Heartvalves, Rheumatic or
Artificial) type 2 VHD, which refers to AF patients with ‘VHD needing therapy with a
VKA or a non-VKA oral anticoagulant also taking into consideration CHA2DS2-VASc
score risk factor components.
KW - antithrombotic therapy
KW - atrial fibrillation
KW - antithrombotic therapy
KW - atrial fibrillation
UR - http://hdl.handle.net/10807/109562
U2 - 10.1160/TH-17-10-0709
DO - 10.1160/TH-17-10-0709
M3 - Article
SN - 0340-6245
VL - 117
SP - 2215
EP - 2236
JO - Thrombosis and Haemostasis
JF - Thrombosis and Haemostasis
ER -