Poor Treatment of Abnormal Heart Rhythm Puts Patients' Lives at Risk

Campaign Calls for Urgent Action to Improve Patients' Health and Reduce Costs to National Health Systems

LONDON, November 23, 2010 - The lives of thousands of patients with atrial fibrillation (AF) could be
at risk due to poor diagnosis, failure to follow treatment guidelines and
lack of quality information for patients suffering from this debilitating
heart condition, warns a report[1] published today by the AF AWARE
partnership. The report argues that poor diagnosis and treatment of AF may
lead to increased risk of hospitalization, stroke and other cardiovascular
complications, as well as to unnecessary costs to individuals and to
healthcare systems in Europe. These findings come at a time when experts are
meeting in London to exchange insights about the effective management of AF,
at the EuropeAF conference. The findings have prompted an urgent call from
the AF AWARE partnership for European-wide improvements.

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Six million people across Europe are affected by AF[1], making it the
most common cardiac arrhythmia (abnormal heart rhythm). While common symptoms
include palpitations, shortness of breath and dizziness, some patients with
AF experience no symptoms. AF increases a person's risk of stroke by four to
five fold.[2]

"AF is a serious, progressive and chronic disease, which can have
devastating consequences on patients and healthcare systems" said Professor
Günter Breithardt, spokesperson for the World Heart Federation. "This report
highlights missed opportunities to manage AF more effectively, saving costs
to European healthcare systems and most importantly, saving patients' lives."

The report reveals inconsistencies in adherence to treatment guidelines,
inadequate patient resources, and a lack of country-level estimates of AF
incidence and prevalence, which raises concerns that AF may be vastly
underdiagnosed. This may hinder effective planning within national healthcare
systems.

The report highlights that AF may cost the European Union EUR10 billion
per year, based on a French estimate of a total average healthcare costs per
year of EUR3,220 per AF patient. However, costs could be greatly reduced
through the use of screening tools in primary care. As a study from the UK
indicated, opportunistic screening of primary care patients can cost
approximately GBP200 per patient, but is likely to lead to cost savings,
avoiding more expensive secondary care.

The report also highlights substantial costs related to loss of work due
to sickness absence, loss of productivity while at work and the need for
early retirement. In Italy and Germany, these indirect costs have been
estimated at over EUR3,000 per AF patient per year, while in the Netherlands,
Greece and France these costs are in the hundreds of euros for each patient.
The result is increased pressure on individuals with AF, their caregivers,
employers, as well as the healthcare and welfare systems.

In response to the report, the AF AWARE partnership, led by the World
Heart Federation and the Stroke Alliance for Europe, is calling for immediate
action in four areas:

    1. Wider availability and use of disease registries, to get a more
       accurate estimate of AF prevalence and assess the true burden of the
       disease

    2. More educational tools on interpreting and applying treatment
       guidelines to country-specific needs

    3. An assessment of clinician training needs, patient information gaps
       and treatment preferences

    4. Quality patient materials, enabling patients to become true partners
       in making treatment decisions, with appropriate support from their
       clinician

"AF is a growing public health concern, with prevalence set to double by
2050" said Dr Markus Wagner, President, Stroke Alliance for Europe. "The AF
AWARE partnership is calling for urgent steps to be taken now to improve care
for AF patients in Europe and reduce the physical, psychological and economic
impact of this disease."

The activities of the AF AWARE Group are supported through an educational
grant by sanofi-aventis

Notes to Editor

About Atrial Fibrillation (AF)

AF results from abnormal electrical activity in the upper chambers of the
heart (atria), leading to an irregular heart rhythm which prevents the blood
from efficiently being pumped toward the rest of the body.[3] Common symptoms
of AF include palpitations (a rapid, irregular, "flopping" movement or
pounding sensation in the chest), shortness of breath, dizziness and feeling
of heaviness in the chest.[4] Age, obesity, hypertension, myocardial
infarction (MI), congestive heart failure (CHF) and valvular heart
diseases[5] put patients at increased risk of developing AF and AF itself
worsens the prognosis of patients with risk factors for cardiovascular
diseases such as stroke or myocardial infarction.[4],[6]

AF AWARE

The AF AWARE (Atrial Fibrillation AWareness And Risk Education) campaign
dedicated to gaining greater recognition of atrial fibrillation (AF) as a
major international public health concern through exposing current
misperceptions of the condition and focusing attention on the realities of
the disease. The campaign calls for urgent steps to be taken to improve the
diagnosis and care of patients with AF and the prevention of associated
cardiovascular conditions. AF AWARE was launched in 2009 by the World Heart
Federation, the Stroke Alliance For Europe, the Atrial Fibrillation
Association and the European Heart Rhythm Association. It is supported by an
unrestricted educational grant from sanofi-aventis.

About the "Atrial Fibrillation in Europe: How AWARE are you?"
report

The report was authored by independent health economist Leela Barham, on
commission of the Stroke Alliance for Europe (SAFE) and the World Heart
Federation and funded by an unrestricted grant from sanofi aventis. The study
was initiated in response to a perceived lack of awareness of AF and a lack
of comparable information and data across Europe. The research involved an
English-language literature review of relevant publications between 2005 and
2010, as well as a survey of member organizations of the World Heart
Federation and the Stroke Alliance for Europe (SAFE) between April and
September 2010.

About the World Heart Federation

The World Heart Federation is dedicated to leading the global fight
against heart disease and stroke with a focus on low- and middle-income
countries via a united community of more than 200 member organizations. With
its members, the World Heart Federation works to build global commitment to
addressing cardiovascular health at the policy level, generates and exchanges
ideas, shares best practice, advances scientific knowledge and promotes
knowledge transfer to tackle cardiovascular disease - the world's number one
killer. It is a growing membership organization that brings together the
strength of medical societies and heart foundations from more than 100
countries. Through our collective efforts we can help people all over the
world to lead longer and better heart-healthy lives.
www.worldheart.org

About the Stroke Alliance for Europe (SAFE)

The Stroke Alliance for Europe is the leading European patient
organisation solely concerned with helping everyone affected by stroke in
Europe. Our vision is to have a world where there are fewer strokes, and all
those touched by stroke get the help they need.

We work towards all patients in Europe with stroke having access to a
continuum of care, from prevention and risk identification, through emergency
response to organised stroke units in the acute phase, to appropriate
rehabilitation and secondary prevention by 2015.

Every 20 seconds someone in Europe has a stroke. A stroke does not
discriminate. It can happen to anyone at any point in their life. Strokes are
sudden and their consequences can be devastating.

About Atrial Fibrillation Association (AFA)

Atrial Fibrillation Association is an international organisation which
provides information, support and access to established, new or innovative
treatments for Atrial Fibrillation (AF).

AFA aims to:

    1. To provide support and information on Atrial Fibrillation to those
       affected by this condition

    2. To advance the education of the medical profession and the general
       public on the subject of Atrial Fibrillation

    3. To promote research into the management of Atrial Fibrillation

AFA-International aims to ensure that anyone presenting symptoms of AF
receives the correct diagnosis, the appropriate treatment, informed support
and sign posting to an appropriate medical professional.

www.atrialfibrillation.org.uk

www.afa-international.org

References

[1] Barham, L. Atrial Fibrillation in Europe: How AWARE are you?,
November 2010

[2] PA Wolf, RD Abbott and WB Kannel. Atrial fibrillation as an
independent risk factor for stroke: the Framingham Study. Stroke
1991;22;983-988. URL: stroke.ahajournals.org/cgi/reprint/22/8/983 -
Last accessed: 27.10.2010

[3] The Task Force for the Management of Atrial Fibrillation of the
European Society of Cardiology (ESC), Guidelines for the management of atrial
fibrillation, European Heart Journal (2010) 31, 2369-2429. URL:
www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments
/guidelines-afib-FT.pdf - last accessed: 27.10.2010

[4] Benjamin E.J. et al., Impact of Atrial Fibrillation on the Risk of
Death: The Framingham Heart Study. Circulation 1998;98:946-952

[5] Benjamin E.J. et al., Prevention of atrial fibrillation: report from
a national heart, lung, and blood institute workshop. Circulation
2009;119(4): 606-618

[6] Wachtell, K. et al., Angiotensin II receptor blockade reduces
new-onset atrial fibrillation and subsequent stroke compared to atenolol,
Journal of the American College of Cardiology 2005;45(5):712-719

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Contact Details: For more information, please contact: Charanjit Jagait, Director of Communications, World Heart Federation, Tel: +41(0)22-807-0334, Email: charanjit.jagait at worldheart.org; Dafni Kokkidi, Weber Shandwick, Tel: +44(0)207-067-0245, Email: dafni.kokkidi at webershandwick.com