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(Circulation. 2009;119:606-618.)
© 2009 American Heart Association, Inc.

Special Report

Prevention of Atrial Fibrillation

Report From a National Heart, Lung, and Blood Institute Workshop

Emelia J. Benjamin, MD, ScM; Peng-Sheng Chen, MD; Diane E. Bild, MD, MPH; Alice M. Mascette, MD; Christine M. Albert, MD, MPH; Alvaro Alonso, MD, PhD; Hugh Calkins, MD; Stuart J. Connolly, MD; Anne B. Curtis, MD; Dawood Darbar, MD; Patrick T. Ellinor, MD, PhD; Alan S. Go, MD; Nora F. Goldschlager, MD; Susan R. Heckbert, MD, PhD; José Jalife, MD; Charles R. Kerr, MD; Daniel Levy, MD; Donald M. Lloyd-Jones, MD, ScM; Barry M. Massie, MD; Stanley Nattel, MD; Jeffrey E. Olgin, MD; Douglas L. Packer, MD; Sunny S. Po, MD, PhD; Teresa S.M. Tsang, MD; David R. Van Wagoner, PhD; Albert L. Waldo, MD; D. George Wyse, MD, PhD

From Boston University Schools of Medicine and Public Health, Boston, Mass (E.J.B.); Framingham Heart Study, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, Mass (E.J.B., D.L.); Krannert Institute of Cardiology, Indiana University, Indianapolis (P.C.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (D.E.B., A.M.M.); Brigham and Women’s Hospital, Boston, Mass (C.M.A.); University of Minnesota, Minneapolis (A.A.); Johns Hopkins Hospital, Baltimore, Md (H.C.); McMaster University, Hamilton, Ontario, Canada (S.J.C.); University of South Florida, Tampa (A.B.C.); Vanderbilt University School of Medicine, Nashville, Tenn (D.D.); Massachusetts General Hospital, Harvard Medical School, Boston (P.T.E.); Kaiser Permanente of Northern California, Oakland (A.S.G.); University of California, San Francisco (A.S.G., N.F.G., J.E.O.); University of Washington, Seattle (S.R.H.); University of Michigan, Ann Arbor (J.J.); St Paul’s Hospital and University of British Columbia, Vancouver, British Columbia, Canada (C.R.K.); Northwestern University Feinberg School of Medicine, Chicago, Ill (D.M.L.-J.); University of California and San Francisco Veterans Affairs Medical Center, San Francisco, Calif (B.M.M.); Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (S.N.); Mayo Clinic Rochester, Rochester, Minn (D.L.P., T.S.M.T.); University of Oklahoma Health Sciences Center, Oklahoma City (S.S.P.); Cleveland Clinic, Cleveland, Ohio (D.R.V.W.); Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, Ohio (A.L.W.); and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada (D.G.W.).

Correspondence to Emelia J. Benjamin, MD, ScM, Framingham Heart Study, 73 Mount Wayte Ave, Suite 2, Framingham, MA 01702-5827. E-mail emelia{at}bu.edu

The National Heart, Lung, and Blood Institute convened an expert panel April 28 to 29, 2008, to identify gaps and recommend research strategies to prevent atrial fibrillation (AF). The panel reviewed the existing basic scientific, epidemiological, and clinical literature about AF and identified opportunities to advance AF prevention research. After discussion, the panel proposed the following recommendations: (1) enhance understanding of the epidemiology of AF in the population by systematically and longitudinally investigating symptomatic and asymptomatic AF in cohort studies; (2) improve detection of AF by evaluating the ability of existing and emerging methods and technologies to detect AF; (3) improve noninvasive modalities for identifying key components of cardiovascular remodeling that promote AF, including genetic, fibrotic, autonomic, structural, and electrical remodeling markers; (4) develop additional animal models reflective of the pathophysiology of human AF; (5) conduct secondary analyses of already-completed clinical trials to enhance knowledge of potentially effective methods to prevent AF and routinely include AF as an outcome in ongoing and future cardiovascular studies; and (6) conduct clinical studies focused on secondary prevention of AF recurrence, which would inform future primary prevention investigations.

Key Words: atrial fibrillation • atrium • epidemiology • prevention • risk factors • National Heart, Lung, and Blood Institute

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