An international research consortium has announced the launch of AF-B-STEP, a four-year research project designed to improve how atrial fibrillation (AF) is detected, quantified and treated worldwide. AF-B-STEP brings together 18 partners from Europe and Canada with the collective goal of developing reliable, standardised methods to measure AF burden, the amount of time an individual spends in AF, and to understand how this influences stroke risk, heart failure and patients’ daily lives, as per a European Society of Cardiology (ESC) press release.
“The results are intended to help physicians make more precise decisions about who needs which treatment based on the AF burden,” said Paulus Kirchhof (University Medical Center Hamburg-Eppendorf [UKE], Hamburg, Germany), coordinator of the AF-B-STEP project. “The goal of AF-B-STEP is to contribute to a measurable reduction in strokes and heart failure in the long term, while simultaneously avoiding unnecessary treatments in people with a low atrial fibrillation burden.”
“For too long, atrial fibrillation has been treated as a simple ‘yes-or-no’ condition,” added Helmut Pürerfellner (Ordensklinikum Linz, Linz, Austria), president of the European Heart Rhythm Association (EHRA). “AF-B-STEP has the potential to change clinical practice by linking AF burden to meaningful outcomes, such as stroke and heart failure, ultimately improving care for millions of patients worldwide.”
The project begins by assembling and analysing anonymised real-world data from more than 100,000 patients worldwide. By linking AF burden to outcomes like stroke, heart failure, cardiovascular death, quality of life, and cognitive and cardiac function, the consortium aims to precisely quantify how AF burden drives clinical risk. At the same time, AF-B-STEP partners—including manufacturers of implantable cardiac devices and wearable technologies, such as smartwatches and fitness trackers—will develop standardised methods for recording and presenting AF burden.
The project’s goal is to create clear burden categories: low AF burden (no further investigations or therapy required); moderate AF burden (additional diagnostic evaluation needed); and high AF burden (immediate initiation of anticoagulation and rhythm control therapy). This approach is expected to enable better patient stratification, support future treatment guidelines, and strengthen the role of AF burden in clinical decision-making, according to the ESC.
“By addressing the unmet needs in atrial fibrillation management, this large, concerted collaboration will be foundational to help guide future efforts to improve the management of AF globally,” stated Mirko De Melis, a distinguished clinical research advisor at Medtronic Bakken Research Center in Maastricht, The Netherlands. Medtronic serves as the industry lead for the AF-B-STEP project.
AF-B-STEP is funded with approximately €18 million from the Innovative Health Initiative (IHI), with contributions from both the European Union (EU) and industry partners.
