The increasing ageing of the general population has led to a significant burden of multimorbidity in the general population, requiring significant changes to healthcare and management, as well as clinical approaches. Hence, increasing attention to the progressively increasing burden of multimorbidity and the need for more integrated care management in patients with chronic long-term conditions. Even in the most common heart rhythm disorder, atrial fibrillation (AF), the presence of multimorbidity has proven to significantly influence clinical management and prognosis. The burden of multimorbidity in AF patients, similar to the overall general population, requires new strategies to manage patients and reduce the risk of adverse outcomes. There is also a close relationship between AF and the concept of ‘frailty’, which is a clinical syndrome characterized by reduced physio-logical reserve and increased vulnerability.

Given this background, the European Union through the Horizon 2020 research programme has funded the ‘Atrial fibrillation integrated approach in frail, multimorbid and polymedicated older people’ (AFFIRMO) Programme (grant agreement no. 899871). Central to the AFFIRMO Programme will be the inclusion of the comprehensive geriatric assessment (CGA) into the ABC pathway, to provide a comprehensive evaluation of health status in elderly multimorbid patients and to characterize each patient by the level of frailty and specifically manage functional status domains.