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Review
. 2024 Aug 7;13(16):4621.
doi: 10.3390/jcm13164621.

Multidisciplinary Approach in Atrial Fibrillation: As Good as Gold

Fabiana Lucà  1 , Maurizio Giuseppe Abrignani  2 , Fabrizio Oliva  3 , Maria Laura Canale  4 , Iris Parrini  5 , Adriano Murrone  6 , Carmelo Massimiliano Rao  1 , Martina Nesti  7 , Stefano Cornara  8 , Irene Di Matteo  3 , Michela Barisone  9 , Simona Giubilato  10 , Roberto Ceravolo  11 , Carlo Pignalberi  12 , Giovanna Geraci  13 , Carmine Riccio  14 , Sandro Gelsomino  15 , Furio Colivicchi  12 , Massimo Grimaldi  16 , Michele Massimo Gulizia  17
Affiliations
Review

Multidisciplinary Approach in Atrial Fibrillation: As Good as Gold

Fabiana Lucà et al. J Clin Med. .

Abstract

Atrial fibrillation (AF) represents the most common sustained arrhythmia necessitating dual focus: acute complication management and sustained longitudinal oversight to modulate disease progression and ensure comprehensive patient care over time. AF is a multifaceted disorder; due to such a great number of potential exacerbating conditions, a multidisciplinary team (MDT) should manage AF patients by cooperating with a cardiologist. Effective management of AF patients necessitates the implementation of a well-coordinated and tailored care pathway aimed at delivering optimized treatment through collaboration among various healthcare professionals. Management of AF should be carefully evaluated and mutually agreed upon in consultation with healthcare providers. It is crucial to recognize that treatment may evolve due to the emergence of new risk factors, symptoms, disease progression, and advancements in treatment modalities. In the context of multidisciplinary AF teams, a coordinated approach involves assembling a diverse team tailored to meet individual patients' unique needs based on local services' availability.

Keywords: atrial fibrillation; multi-integrated approach; multidisciplinary team.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Multidisciplinary team for management.
Figure 2
Figure 2
(A–C) Atrial fibrillation better care (ABC) pathway.
Figure 3
Figure 3
Association between endocrinological disorders and AF. AF and endocrine disorders are commonly associated. Diabetes mellitus (DM) has been associated with a heightened risk of AF. Obesity is linked to an elevated susceptibility to AF. A relationship between thyroid disorders and AF has also been well assessed. Pheochromocytoma, hyperaldosteronism, and hypoparathyroidism have also been associated with AF. Abb: AF: atrial fibrillation; AH: arterial hypertension; HF: heart failure. ↑: Increasing.
Figure 4
Figure 4
Association between cardiovascular risk factors, comorbidities, AF, and cognitive impairment. Cognitive impairment and AF share many risk factors and underlying comorbidities and correlate with the development of dementia in AF patients.
Figure 5
Figure 5
Mechanisms of COPD exacerbating AF onset and recurrence.
Figure 6
Figure 6
Relationship between obstructive sleep apnea and atrial fibrillation. Abb: HRV: heart rate variability; PVR: pulse rate variability; LF/HF: low-to-high frequency ratio; AERP: atrial effective refractory period; NGF: nerve growth factor. ↑: increase; ↓: decrease.
Figure 7
Figure 7
Relationship between chronic kidney disease and atrial fibrillation.
Figure 8
Figure 8
Pregnancy heart team (PHT) involvement in AF patient management. PHT aims to provide the quality of care for pregnant women with complex medical conditions. This team would comprise various specialists, including cardiologists, gynecologists, anesthesiologists, as well as other experts, such as geneticists, neonatologists, cardiac surgeons, endocrinologists, and oncologists. The PHT aims to provide comprehensive care, from pre-conception counseling to postpartum follow-up, including monitoring during pregnancy and delivery.
Figure 9
Figure 9
Technologies of the wearables.
See this image and copyright information in PMC

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