AF Burden

Q: How do you define Atrial Fibrillation (AF) burden?

Answer: There is no consensus definition, but AF burden is usually described as the "percentage of time in AF during a monitoring period".

Clinical significance: The duration of the most extended recorded episode of AF is considered an additional risk factor of AF associated with thromboembolic risk.

It is a relatively new concept that has gained significance over the last couple of years. The author of this question encourages readers to review the following references from the existing literature.

#cardiology

References:

1. Becher N, Metzner A, Toennis T, Kirchhof P, Schnabel RB. Atrial fibrillation burden: a new outcome predictor and therapeutic target. Eur Heart J. 2024 Aug 16;45(31):2824-2838. doi: 10.1093/eurheartj/ehae373. PMID: 38953776; PMCID: PMC11328870.

2. Doehner W, Boriani G, Potpara T, Blomstrom-Lundqvist C, Passman R, Sposato LA, Dobrev D, Freedman B, Van Gelder IC, Glotzer TV, Healey JS, Karapanayiotides T, Lip GYH, Merino JL, Ntaios G, Schnabel RB, Svendsen JH, Svennberg E, Wachter R, Haeusler KG, Camm AJ. 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. 2025 Mar 5;27(3):euaf019. doi: 10.1093/europace/euaf019. PMID: 40073206; PMCID: PMC11901050.

3. AlTurki A, Essebag V. Atrial Fibrillation Burden: Impact on Stroke Risk and Beyond. Medicina (Kaunas). 2024 Mar 26;60(4):536. doi: 10.3390/medicina60040536. PMID: 38674182; PMCID: PMC11051719.

4. Doundoulakis I, Nedios S, Zafeiropoulos S, Vitolo M, Della Rocca DG, Kordalis A, Shamloo AS, Koliastasis L, Marcon L, Chiotis S, Sorgente A, Soulaidopoulos S, Imberti JF, Botis M, Pannone L, Gatzoulis KA, Sarkozy A, Stavrakis S, Boriani G, Boveda S, Tsiachris D, Chierchia GB, de Asmundis C. Atrial fibrillation burden: Stepping beyond the categorical characterization. Heart Rhythm. 2025 May;22(5):1179-1187. doi: 10.1016/j.hrthm.2024.08.051. Epub 2024 Aug 27. PMID: 39197738.