Scientific Publications

Read in and find out

View background literature as well as new publications by the AF-B-STEP consortium. Once new publications are available, we list them here. All IHI-funded publications are required to be Open Access, meaning the references on this page are linked directly to the full text publication.

Total number of AF-B-STEP publications:
5
2026
Publications:
5
  • Published: June 2026

    AF-B-STEP: a global collaboration to reduce the burden of atrial fibrillation and advance its quantification and treatment

    Obergassel J, de Melis M, and Kirchhof P (2026), European Heart Journal, 47(31): pp. 4185–4187

    Currently, atrial fibrillation (AF) is still largely treated as a binary diagnosis, overlooking the wide range of episode patterns and intensities. More precise, quantitative measures of AF burden are therefore needed to better understand disease progression, assess risk and enable more personalised treatment and management.

    Further reading
  • Published: October 2026

    Calibration and clarification: atrial fibrillation burden estimated by ECG patch recordings

    Tesfamariam M and Kirchhof P (2026), Heart (online ahead of print)

    Atrial fibrillation (AF) is traditionally diagnosed as a binary condition, but growing evidence suggests that AF burden - the proportion of time a person spends in AF - may provide important additional clinical information. Large-scale rhythm-monitoring data highlight substantial variation in AF burden and support its potential role in refining cardiovascular risk assessment and guiding treatment. Further research, including the AF-B-STEP project, will investigate how AF burden can better inform screening, treatment and health policy.

    Further reading
  • Published: July 2026

    Interactions of blood biomolecules with early rhythm control in atrial fibrillation patients: exploratory analysis of the EAST-AFNET 4 biomolecule study

    Al-Taie C et al. (2026), EP Europace, 28(7): euag149

    Early rhythm control (ERC) reduces cardiovascular events in patients with atrial fibrillation (AF), but whether its benefits vary with the severity of AF-associated conditions is unclear. In the EAST-AFNET 4 biomolecule study, 14 circulating biomarkers were analysed in 1,586 patients. ERC reduced cardiovascular outcomes consistently across biomarker concentrations, with no evidence of treatment interaction for 13 of 14 biomarkers. A potentially attenuated benefit in patients with low BMP10 concentrations was observed in exploratory analyses and warrants further investigation.

    Further reading
  • Published: March 2026

    Kidney disease increases the risk of cardiovascular events in patients with device-detected atrial fibrillation: NOAH-AFNET 6

    Goette A et al. (2026), EP Europace, 28(4): euag083

    A prespecified analysis of the NOAH-AFNET 6 trial shows that impaired kidney function is associated with a higher risk of cardiovascular events in patients with device-detected atrial fibrillation. Age and estimated glomerular filtration rate (eGFR) were among the strongest predictors of cardiovascular events, particularly cardiovascular death, suggesting that eGFR may help refine risk assessment in this patient population.

    Further reading
  • Published: March 2026

    Pre-procedural time spent in atrial fibrillation using intermittent ECG monitoring is associated with arrhythmia recurrence after ablation: the ISOLATION cohort study

    Habibi Z et al. (2026), Europace, 28 (3): euag044
    Atrial fibrillation (AF) burden may provide a more precise picture of treatment response than conventional AF classification. In this study, the percentage of time patients spent in AF before ablation independently predicted arrhythmia recurrence. Notably, patients classified as having paroxysmal AF but with a high AF burden had recurrence rates similar to those with persistent AF, highlighting the potential of quantitative AF burden measures to improve risk assessment and personalise treatment.
    Further reading

Background Literature

  • Becher N et al. (2024). Atrial fibrillation burden: a new outcome predictor and therapeutic target. European Heart Journal, 45: pp. 2824–2838.

    Further reading

  • Doehner W et al. (2025). Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association. Europace, 27.

    Further reading

  • Healey JS et al. (2024). Apixaban for stroke prevention in subclinical atrial fibrillation. New England Journal of Medicine, 390: pp. 107–117.

    Further reading

  • Kirchhof P et al. (2023). Anticoagulation with Edoxaban in Patients with Atrial High-Rate Episodes. New England Journal of Medicine, 389: pp. 1167–1179.

    Further reading

  • Kirchhof P et al. (2020). Early rhythm-control therapy in patients with atrial fibrillation. New England Journal of Medicine, 383 (14): pp. 1305–1316.

    Further reading

  • Kirchhof P, Parwani AS, and Schenker N (2025). Does atrial fibrillation ablation prevent cardiovascular death, stroke, and heart failure events? Heart Rhythm, 22: pp. 2224–2226.

    Further reading

  • Marrouche NF et al. and CASTLE-AF Investigators (2018). Catheter ablation for atrial fibrillation with heart failure. New England Journal of Medicine, 378 (5): pp. 417–427.

    Further reading

  • Perez MV et al. (2019). Large-scale assessment of a smartwatch to identify atrial fibrillation. New England Journal of Medicine, 381 (20): pp. 1909–1917.

    Further reading

  • Sanna T et al. and CRYSTAL AF Investigators (2014). Cryptogenic stroke and underlying atrial fibrillation. New England Journal of Medicine, 370 (26): pp. 2478–2486.

    Further reading

  • Schnabel RB et al. (2015). 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: A cohort study. The Lancet, 386 (9989): pp. 154–162.

    Further reading

  • Svennberg E et al. (2025). Transforming atrial fibrillation management by targeting comorbidities and reducing atrial fibrillation burden: the 10th AFNET/EHRA consensus conference. Europace, 27.

    Further reading

  • Svendsen JH et al. (2021). Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): A randomised controlled trial. The Lancet, 398 (10310): pp. 1507–1516.

    Further reading

  • Zeemering S et al. (2025). Estimated atrial fibrillation burden on early rhythm-control and cardiovascular events in the EAST-AFNET 4 trial. eClinicalMedicine, 88: 103457.

    Further reading

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