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The German Competence Network on Atrial Fibrillation (AFNET)

Das Kompetenznetz Vorhofflimmern (AFNET)

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Abstract

The German Competence Network on Atrial Fibrillation (AFNET) is an interdisciplinary national research network funded by the Federal Ministry of Education and Research (BMBF) since 2003. The AFNET aims at improving treatment of atrial fibrillation (AF), the most frequent sustained arrhythmia of the heart. The AFNET has established a nationwide patient registry on manifestation, diagnostics, and therapy of AF in Germany. The data analyzed to date demonstrate that patients with AF are likely to have multiple comorbidities (hypertension, valvular heart disease, coronary artery disease, diabetes mellitus) and an advanced age. Regarding oral anticoagulation, guideline adherence is very high. Basic research has identified specific changes in atrial tissue during AF-induced remodeling providing the rationale for novel therapeutic interventions. Clinical trials are being carried out to optimize pharmacological and nonpharmacological treatments. The ANTIPAF trial is designed to prove that angiotensin II receptor blockers reduce the incidence of paroxysmal AF. The Flec-SL trial tests the efficacy of a short-term treatment with antiarrhythmic drugs after cardioversion. The Gap-AF trial investigates the impact of complete pulmonary vein (PV) isolation versus incomplete circumferential PV ablation on AF recurrences. The effect of preventive pacing on the recurrence of paroxysmal AF is studied in the BACE-PACE trial.

Zusammenfassung

Das Kompetenznetz Vorhofflimmern (AFNET) ist ein interdisziplinäres bundesweites Forschungsnetzwerk, das seit 2003 vom Bundesministerium für Bildung und Forschung (BMBF) gefördert wird. Ziel des AFNET ist es, die Behandlung von Vorhofflimmern, der häufigsten klinisch bedeutsamen Herzrhythmusstörung, nachhaltig zu verbessern. Das AFNET hat ein deutschlandweites Patientenregister aufgebaut, mit dem eine Bestandsaufnahme der Manifestation sowie der Diagnostik und Therapie von Vorhofflimmern in Deutschland durchgeführt wird. Die bis jetzt analysierten Daten zeigen, dass Patienten mit Vorhofflimmern typischerweise vielfältige Begleiterkrankungen wie Hypertonie, Herzklappenfehler, koronare Herzkrankheit oder Diabetes mellitus sowie ein fortgeschrittenes Alter aufweisen. Bezüglich der oralen Antikoagulation ergeben die Registerdaten eine verhältnismäßig hohe Übereinstimmung mit den Leitlinien. In der Grundlagenforschung konnten spezifische Veränderungen des Vorhofgewebes identifiziert werden, die durch vorhofflimmerninduzierte Umbauvorgänge (Remodeling) hervorgerufen werden. Diese Erkenntnisse liefern die Grundlage für neue therapeutische Ansätze. In den klinischen Studien, die das AFNET durchführt, werden verbesserte medikamentöse und nichtmedikamentöse Behandlungsmethoden überprüft. Die ANTIPAF-Studie will beweisen, dass Angiotensin-II-Rezeptor-Blocker geeignet sind, das Auftreten von paroxysmalem Vorhofflimmern zu reduzieren. Die Flec-SL-Studie testet die Wirksamkeit einer antiarrhythmischen Kurzzeittherapie nach der Kardioversion. Die Gap-AF-Studie untersucht, ob eine vollständige Pulmonalvenenisolation einer unvollständigen überlegen ist. Die Wirkung der präventiven Schrittmacherstimulation zur Verhinderung von Vorhofflimmern wird in der BACE-PACE-Studie untersucht.

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Authors and Affiliations

  1. Department of Medicine C – Cardiology and Angiology, University Hospital, Münster, Germany

    Günter Breithardt & Paulus Kirchhof

  2. Department of Pharmacology and Toxicology, Dresden University of Technology, Dresden, Germany

    Dobromir Dobrev & Ursula Ravens

  3. Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Germany

    Nicolas Doll

  4. Department of Cardiology, Angiology and Pneumology, University of Magdeburg, Magdeburg, Germany

    Andreas Goette

  5. Department of Cardiology/Angiology, Universitäres Herzzentrum gGmbH, Hamburg, Germany

    Boris Hoffmann, Thomas Meinertz & Stephan Willems

  6. Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany

    Ilka Köster & Karl-Heinz Kuck

  7. Department of Medicine I, University Hospital Großhadern, Munich, Germany

    Michael Näbauer & Gerhard Steinbeck

  8. Department of Internal Medicine I, Municipal Hospital, Brandenburg, Germany

    Michael Oeff & Claudia Sprenger

  9. Department of Medicine, Friedrich-Ebert-Krankenhaus GmbH, Neumünster, Germany

    Andreas Schuchert

  10. Competence Network on Atrial Fibrillation*, University Hospital, Münster, Germany

    Günter Breithardt, Dobromir Dobrev, Nicolas Doll, Andreas Goette, Boris Hoffmann, Paulus Kirchhof, Ilka Köster, Karl-Heinz Kuck, Angelika Leute, Thomas Meinertz, Michael Näbauer, Michael Oeff, Ursula Ravens, Andreas Schuchert, Claudia Sprenger, Gerhard Steinbeck & Stephan Willems

  11. Medizinische Klinik und Poliklinik C – Kardiologie und Angiologie, Universitätsklinikum Münster, 48129, Münster, Germany

    Günter Breithardt

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  1. Günter Breithardt
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  2. Dobromir Dobrev
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  4. Andreas Goette
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  5. Boris Hoffmann
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  6. Paulus Kirchhof
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  7. Ilka Köster
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  8. Karl-Heinz Kuck
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  9. Angelika Leute
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  10. Thomas Meinertz
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  11. Michael Näbauer
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  12. Michael Oeff
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  13. Ursula Ravens
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  14. Andreas Schuchert
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  15. Claudia Sprenger
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  16. Gerhard Steinbeck
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  17. Stephan Willems
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Correspondence to Günter Breithardt.

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*(http://www.kompetenznetzvorhofflimmern.de)

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Breithardt, G., Dobrev, D., Doll, N. et al. The German Competence Network on Atrial Fibrillation (AFNET). Herz 33, 548–555 (2008). https://doi.org/10.1007/s00059-008-3177-2

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  • DOI: https://doi.org/10.1007/s00059-008-3177-2

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