Evidence map›Paper›PMID 38940494›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024

Design and deployment of the STEEER-AF trial to evaluate and improve guideline adherence: a cluster-randomized trial by the European Society of Cardiology and European Heart Rhythm Association.

Maciej Sterliński, Karina V Bunting, Giuseppe Boriani, Serge Boveda, Eduard Guasch, Lluís Mont, Kim Rajappan, Philipp Sommer, Samir Mehta, Yongzhong Sun and 5 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04396418 (Stroke Prevention and Rhythm Control Therapy), which is not on this map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04396418 naunknown statusnot on this map

Stroke Prevention and Rhythm Control Therapy: Evaluation of an Educational Programme of the European Society of Cardiology in a Cluster-Randomised Trial in Patients With Atrial Fibrillation

TypeinterventionalSponsorEuropean Society of CardiologyRan2021 to 2025Enrolled1,732ConditionsAtrial FibrillationArmsEducation
3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Trial
  2. Compliance to direct oral anticoagulation therapy and clinical outcomes after catheter ablation for atrial fibrillation: a nationwide cohort study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  3. Implementation of new concise care pathways into a software tool to detect and manage comorbidities in older patients with atrial fibrillation: the Horizon 2020 EHRA-PATHS project.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  4. Article
  5. Article
  6. Educating healthcare professionals to improve AF-CARE: lessons from the ESC/EHRA STEEER-AF trial educational programme.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  7. Lifestyle and risk factor modification in atrial fibrillation: a European Heart Rhythm Association survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  8. Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Review
  9. Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Review
  10. Spotlight on the 2024 ESC/EACTS management of atrial fibrillation guidelines: 10 novel key aspects.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Maciej SterlińskiArrhythmia Center, National Institute of Cardiology, Warsaw, Poland.ORCID 0000-0001-5250-3679
Karina V BuntingInstitute of Cardiovascular Sciences, University of Birmingham, Medical School, Vincent Drive, Birmingham B15 2TT, UK.ORCID 0000-0003-4602-4377
Giuseppe BorianiDivision of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.ORCID 0000-0002-9820-4815
Serge BovedaHeart Rhythm Management Department, Cardiology, Clinique Pasteur, Toulouse, France.ORCID 0000-0002-1280-7042
Eduard GuaschCardiology Department, Clinic Barcelona, Barcelona, Spain.ORCID 0000-0003-4238-5319
Lluís MontInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.ORCID 0000-0002-8115-5906
Kim RajappanCardiology Department, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford, UK.ORCID 0000-0001-8996-2983
Philipp SommerClinic for Electrophysiology, Heart and Diabetes Center NRW, Georgstraße 11, Bad Oeynhausen, Germany.ORCID 0000-0002-3037-8704
Samir MehtaBirmingham Clinical Trials Unit (BCTU), Institute of Applied Health Research, Birmingham, UK.ORCID 0000-0001-7096-513X
Yongzhong SunBirmingham Clinical Trials Unit (BCTU), Institute of Applied Health Research, Birmingham, UK.ORCID 0000-0003-0659-9811
Chris P GaleLeeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.ORCID 0000-0003-4732-382X
Colinda van DeutekomDepartment of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.ORCID 0000-0001-5116-7378
Isabelle C Van GelderDepartment of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.ORCID 0000-0002-7579-1201
Dipak KotechaInstitute of Cardiovascular Sciences, University of Birmingham, Medical School, Vincent Drive, Birmingham B15 2TT, UK.ORCID 0000-0002-2570-9812
STEEER-AF Trial Team

Funding

BayerBirmingham British Heart Foundation AcceleratorBMS/Pfizer AllianceBoehringer IngelheimBritish Heart Foundation FS/CDRF/21/21032Daiichi Sankyo, and Boston ScientificOxford National Institute for Health Research Biomedical Research Centre
6 · The paper itself

Abstract

aimsThe aim is to describe the rationale, design, delivery, and baseline characteristics of the Stroke prevention and rhythm control Treatment: Evaluation of an Educational programme of the European society of cardiology in a cluster-Randomized trial in patients with Atrial Fibrillation (STEEER-AF) trial. METHODS AND

resultsSTEEER-AF is a pragmatic trial designed to objectively and robustly determine whether guidelines are adhered to in routine practice and evaluate a targeted educational programme for healthcare professionals. Seventy centres were randomized in six countries (France, Germany, Italy, Poland, Spain, and UK; 2022-23). The STEEER-AF centres recruited 1732 patients with a diagnosis of atrial fibrillation (AF), with a mean age of 68.9 years (SD 11.7), CHA2DS2-VASc score of 3.2 (SD 1.8), and 647 (37%) women. Eight hundred and forty-three patients (49%) were in AF at enrolment and 760 (44%) in sinus rhythm. Oral anticoagulant therapy was prescribed in 1543 patients (89%), with the majority receiving direct oral anticoagulants (1378; 89%). Previous cardioversion, antiarrhythmic drug therapy, or ablation was recorded in 836 patients (48.3%). Five hundred fifty-one patients (31.8%) were currently receiving an antiarrhythmic drug, and 446 (25.8%) were scheduled to receive a future cardioversion or ablation. The educational programme engaged 195 healthcare professionals across centres randomized to the intervention group, consisting of bespoke interactive online learning and reinforcement activities, supported by national expert trainers.

conclusionThe STEEER-AF trial was successfully deployed across six European countries to investigate guideline adherence in real-world practice and evaluate if a structured educational programme for healthcare professionals can improve patient-level care. CLINICAL

trial registrationClinicaltrials.gov, NCT04396418.

Indexed as

Atrial FibrillationGuideline AdherencePractice Guidelines as TopicAgedAnti-Arrhythmia AgentsAnticoagulantsCardiologyEuropeFemaleHumansMaleMiddle AgedMulticenter Studies as TopicPractice Patterns, Physicians'Pragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicAnti-Arrhythmia AgentsAnticoagulantsAtrial fibrillationGuideline adherenceRhythm controlStroke preventionTrial

Identifiers

PMID38940494
PMCPMC11289729

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.