Atrial fibrillation affects millions of people worldwide, yet how the condition is measured and treated is still evolving. PHRI is part of a new global research initiative working to improve atrial fibrillation diagnosis and care as the only Canadian institute involved.
The Quantifying Atrial Fibrillation Burden to inform Screening, Treatment, and hEalth Policy (AF‑B‑STEP) collaboration brings together 18 leading academic and industry partners from Europe and Canada with the goal of advancing how AF is measured, understood, and treated.
“PHRI is proud to be part of this project which aligns perfectly with our focus on improving health outcomes through research excellence,” said Hertzel Gerstein, interim executive director and senior scientist, PHRI. “Through close collaborations with global colleagues, we are generating evidence that can change practice and improve lives around the world.”
Healey presenting at the AF-B-STEP first meeting in Amsterdam
At PHRI, the project is led by scientist William McIntyre, with senior scientist Jeff Healey as co‑lead. The four‑year project officially launched with a kick‑off meeting held Feb. 3–5 in Amsterdam, the Netherlands.
Atrial fibrillation is the most common sustained cardiac arrhythmia worldwide and significantly increases the risk of stroke and heart failure. It affects approximately one‑third of people over the age of 55 and accounts for two to three percent of healthcare costs in Europe and North America. Despite its widespread impact, AF is still typically diagnosed as either present or absent, without considering how often or how long patients experience the condition.
“While atrial fibrillation burden is widely discussed, its clinical application remains limited by the absence of validated thresholds. AF-B-STEP will address this gap by combining exceptional datasets, experienced investigators, and industry collaborators to enable the practical use of AF burden in clinical care,” said McIntyre
The AF‑B‑STEP consortium will integrate and analyze existing datasets from more than 100,000 patients worldwide, provided by 15 collaborating partners. PHRI is contributing data from several landmark clinical trials, including ACTIVE, AVERROES, ARTESiA, and ASSERT.
By analyzing this anonymized data, researchers aim to better understand AF burden, the amount of time a person spends in atrial fibrillation, and how it affects the risk of stroke, heart failure, hospitalization, and overall quality of life. The project will also explore how AF burden impacts cardiac and brain function.
McIntyre presenting at the AF-B-STEP kick-off meeting.
“By studying these large datasets and identifying patterns across different patient populations, we hope to gain clearer insights into the various forms of atrial fibrillation and find ways to reduce AF burden and improve outcomes for patients,” added McIntyre.
Although implantable cardiac devices and wearable technologies such as smartwatches are increasingly used to detect atrial fibrillation, there are currently no consistent standards for how this data should be reported or used to guide diagnosis and treatment decisions.
To address this gap, AF‑B‑STEP will work closely with device and technology manufacturers to develop uniform standards for how AF and AF burden are detected, measured, and reported. The long‑term goal is to define clinically meaningful AF‑burden categories that can guide diagnosis, treatment strategies, and future clinical guidelines.
The project is coordinated by the University Heart and Vascular Center at the University Medical Center Hamburg‑Eppendorf (UKE) in Germany, with industry leadership from the Medtronic Bakken Research Center in Maastricht, The Netherlands. It is funded over four years through the Innovative Health Initiative (IHI), with support from the European Union and industry partners totaling approximately €18 million.
“PHRI has a long track record of leading and contributing to research that shapes cardiovascular care worldwide,” said Healey. “AF‑B‑STEP reflects our commitment to working with global partners to generate evidence that addresses real clinical needs and ultimately improves patient care.”
