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ESC 25: STEEER-AF Cluster Randomised Trial by the ESC and EHRA

Published: 01 Sep 2025

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ESC Congress 2025 - Exploratory findings from STEEER-AF suggest that a comprehensive educational programme for stroke prevention and rhythm control therapy improved outcomes for patients with atrial fibrillation.

Dr Dipak Kotecha (University of Birmingham, Birmingham, UK) joins us to discuss findings from the STEEER-AF (NCT04396418) cluster randomised trial by the ESC and EHRA. The prospective, international, controlled trial aimed to investigate the effect of a comprehensive educational programme for healthcare professionals on stroke prevention and rhythm control therapy in patients with AF. Patients from centres across six European countries were randomised to either a structured education programme or no additional education.

Findings showed that in the stroke prevention group, of those who were fully guideline adherent, patients were significantly less likely to have the composite clinical outcome, which included mortality, stroke and transient ischemic attack. In this group, there was a 33% reduction in adverse events, if guideline adherent. This did not occur in the rhythm control analysis, though there were some groups with prognostic improvement.

Interview Questions: 

  1. What is the background behind the STEEER-AF trial?
  2. Could you tell us about the comprehensive educational programme?
  3. What was the study design and patient population?
  4. What were the key findings?
  5. What are the take-home messages for practice
  6. What further research is needed in this area, and what are the next steps?

Recorded on-site at ESC Congress 2025, Madrid.

Editors: Jordan Rance, Yazmin Sadik.
Videographers: Mike Knight, Dan Brent, Oliver Miles, Tom Green, David-Ben-Harosh.
Support: This is an independent interview produced by Arrhythmia Academy.

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