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


AF-related stroke is a clear challenge to the future sustainability of healthcare systems, and demands high-level attention in every nation in Europe

Atrial fibrillation (AF) is the most common sustained heart rhythm disturbance (arrhythmia). People with AF are three to five times more likely to suffer a devastating, debilitating, disabling and often fatal stroke than people without AF. AF-related strokes cause unacceptably high levels of death and disability, and the scale of the problem across Europe is increasing as our populations age.

We need to act now to prevent AF-related stroke

The number of people with AF is increasing and, by 2060, it is estimated that nearly 18 million adults over the age of 55 will have AF. Yet with early detection, access to appropriate therapies and ongoing care and support, many AF‑related strokes can be prevented. Appropriate stroke-prevention therapies have been shown to save lives and prevent disability in people with AF, and reduce AF-related hospital admissions, length of stay, outpatient visits and healthcare costs.

This paper arrives at a critical moment for strategic health policymaking

Preventing stroke offers policymakers huge potential to improve patient outcomes and help build more sustainable healthcare systems. Non-communicable diseases (NCDs) are currently a major focus at the European level, with increasing attention being given to stroke. Recent developments include a European Union Joint Action on chronic diseases, a World Health Organization (WHO) European Region action plan for NCDs and the recently published Stroke Action Plan for Europe. This has created a new opportunity to advance AF-related stroke prevention at all levels - the key question is if we will seize it.

Broadly AF-related stroke is under-recognised by the general public and policymakers

AF – and the link between AF and stroke – has so far been absent from many of these high level discussions. Meanwhile, consistent gaps and inequalities persist, including in rate of detection, access and uptake of first-line therapies and ongoing care for the prevention of AF-related stroke. An evidence-based consensus on the current state of play, and an analysis of leading implementation models and key system barriers and opportunities faced by decision-makers is therefore a vital contribution.

This White Paper aims to enable stakeholders at all levels to address this serious public health issue

This White Paper is the culmination of a consultative and consensus-driven process. It begins by placing AF and AF-related stroke within the policy context, then focuses on four areas that are recognised by experts as critical to driving meaningful change for patients. In each of these areas, recommendations are made for how AF can be prioritised to improve outcomes for patients and maximise benefits for the wider healthcare system.

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