EHRA White Paper: knowledge gaps in arrhythmia management—status 2019

Author:

Goette Andreas12,Auricchio Angelo3,Boriani Giuseppe4,Braunschweig Frieder5,Terradellas Josep Brugada6,Burri Haran7,Camm A John8,Crijns Harry9,Dagres Nikolaos10,Deharo Jean-Claude11,Dobrev Dobromir12,Hatala Robert13,Hindricks Gerhard10,Hohnloser Stefan H14,Leclercq Christophe15,Lewalter Thorsten1617,Lip Gregory Y H1819,Merino Jose Luis20,Mont Lluis6,Prinzen Frits21,Proclemer Alessandro22,Pürerfellner Helmut23,Savelieva Irina8,Schilling Richard24,Steffel Jan25,van Gelder Isabelle C26,Zeppenfeld Katja27,Zupan Igor28,Heidbüchel Hein29,Boveda Serge30,Defaye Pascal31,Brignole Michele32,Chun Jongi33,Guerra Ramos Jose M34,Fauchier Laurent35,Svendsen Jesper Hastrup3637,Traykov Vassil B38,Heinzel Frank R39,

Affiliation:

1. St. Vincenz-Krankenhaus GmbH, Cardiology and Intensive Care Medicine, Am Busdorf 2, Paderborn, Germany

2. Working Group Molecular Electrophysiology, University Hospital Magdeburg, Magdeburg, Germany

3. Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano (Ticino), Switzerland

4. Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy

5. Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden

6. Department of Cardiology, Hospital Clinic, University of Barcelona, Barcelona, Spain

7. Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland

8. St. George's, University of London, Molecular and Clinical Sciences Research Institute, London, UK

9. Department of Cardiology and Cardiovascular Research Institute Maastricht (CARIM), Maastricht UMC+, Maastricht, The Netherlands

10. Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany

11. Department of Cardiology, Aix Marseille Université, CHU la Timone, Marseille, France

12. University Duisburg-Essen, Institute of Pharmacology, Essen, Germany

13. Department of Cardiology and Angiology, National Cardiovascular Institute, NUSCH, Bratislava, Slovak Republic

14. Division of Clinical Electrophysiology, Department of Cardiology, J.W. Goethe University, Frankfurt, Germany

15. Univ Rennes, CHU Rennes, LTSI-UMR1099, Rennes, France

16. Department of Cardiology and Intensive Care, Hospital for Internal Medicine Munich South, Munich, Germany

17. Department of Cardiology, University of Bonn, Bonn, Germany

18. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK

19. Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

20. Hospital Universitario La Paz, Arrhythmia and Robotic EP Unit, Madrid, Spain

21. Department of Physiology, Maastricht University, Maastricht, Netherlands

22. Cardiology Division, University Hospital Udine, Udine, Italy

23. Department of Cardiology, Ordensklinikum Linz Elisabethinen, Academic Teaching Hospital, Linz, Austria

24. Barts Heart Centre, Barts and the London NHS Trust, London, UK

25. University Heart Center Zurich, Zurich, Switzerland

26. Department Of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands

27. Department of Cardiology, Leiden University Medical Center (Lumc), Leiden, Netherlands

28. Department Of Cardiology, University Clinical Centre Ljubljana, Ljubljana, Slovenia

29. Antwerp University and Antwerp University Hospital, Antwerp, Belgium

30. Cardiology Department, Clinique Pasteur, Toulouse, France

31. CHU Hôpital Albert Michalon, Unité de Rythmologie Service De Cardiologie, FR-38043 Grenoble Cedex 09, France

32. Department of Cardiology, Ospedali Del Tigullio, Via Don Bobbio 25, IT-16033 Lavagna (GE), Italy

33. CCB, Cardiology Department, Med. Klinik Iii, Markuskrankenhaus, Wilhelm Epstein Str. 4, DE-60431 Frankfurt, Germany

34. Unitat d'Aritmies, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

35. Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Université de Tours, Faculté de Médecine, Tours, France

36. Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

37. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

38. Department of Invasive Electrophysiology and Cardiac Pacing, Clinic of Cardiology, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria

39. Charité University Medicine, Campus Virchow-Klinikum, Berlin, Germany

Abstract

Abstract Clinicians accept that there are many unknowns when we make diagnostic and therapeutic decisions. Acceptance of uncertainty is essential for the pursuit of the profession: bedside decisions must often be made on the basis of incomplete evidence. Over the years, physicians sometimes even do not realize anymore which the fundamental gaps in our knowledge are. As clinical scientists, however, we have to halt and consider what we do not know yet, and how we can move forward addressing those unknowns. The European Heart Rhythm Association (EHRA) believes that scanning the field of arrhythmia / cardiac electrophysiology to identify knowledge gaps which are not yet the subject of organized research, should be undertaken on a regular basis. Such a review (White Paper) should concentrate on research which is feasible, realistic, and clinically relevant, and should not deal with futuristic aspirations. It fits with the EHRA mission that these White Papers should be shared on a global basis in order to foster collaborative and needed research which will ultimately lead to better care for our patients. The present EHRA White Paper summarizes knowledge gaps in the management of atrial fibrillation, ventricular tachycardia/sudden death and heart failure.

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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