In 2015, the National Heart Foundation of Australia (NHFA) and the Cardiac Society of Australia and New Zealand (CSANZ) undertook a survey of emerging issues in cardiovascular disease. The goal was to prioritise clinical conditions that would benefit from locally developed contemporary guidelines. Individual diseases were evaluated according to burden of disease, the existence of treatment gaps, an evolving therapeutic landscape, evidence of inequity and the existence of local treatment guidelines. Atrial fibrillation (AF) scored highly in each of these categories. Specifically, AF was recognised as a burdensome condition with increasing prevalence, where large numbers of patients are not treated with anticoagulation, despite the clear benefit of this therapy in stroke prevention. Other factors relevant to AF were:
- the relatively recent availability of non-vitamin K oral anticoagulants (NOACs), with a rapidly evolving evidence base guiding their use;
- variation and uncertainty about best practice use of antiarrhythmic drugs
- increasing availability of AF ablative procedures;
- an increasing prevalence of AF in older people and Aboriginal and Torres Strait Islander peoples.