Open AccessPhysician Stated Atrial Fibrillation Management in Light of Treatment Guidelines: Data From an International, Observational Prospective Survey
Author(s) -
Kowey Peter R.,
Breithardt Günter,
Camm John,
Crijns Harry,
Dorian Paul,
Le Heuzey JeanYves,
Pedrazzini Laurence,
Prystowsky Eric N.,
Salette Geneviève,
Schwartz Peter J.,
TorpPedersen Christian,
Weintraub William
Publication year - 2010
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20737
Subject(s) - medicine , observational study , atrial fibrillation , intensive care medicine , management of atrial fibrillation , medline , cardiology , political science , law
Background: The Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation (RecordAF) study is the first worldwide, prospective, survey of real‐life management of atrial fibrillation (AF) in recently diagnosed patients (n = 5604) with a 1‐year follow‐up. Hypothesis: Surveys of AF management have identified a divergence between guidelines and clinical practice, and an overinterpretation of guidelines in low‐risk patients. Methods: Physicians' theoretical approaches to rhythm and rate control were investigated using a pre‐study questionnaire. Results: One cardiologist, from each of the 583 sites in 6 regions, completed a questionnaire on their practice and management of AF patients. In AF patients with structural heart disease (SHD), amiodarone was the most frequent choice of first‐line rhythm control agents in all regions. Amiodarone or sotalol tended to be the preferred second‐line rhythm control agents, 1 exception being Central/South America. β‐Blockers were the first‐line rate control agents for patients with AF and SHD in all regions, and calcium channel blockers and cardiac glycosides were the most common second‐line rate control treatments in all regions, except Asia. In lone AF patients, propafenone (30.6%), flecainide (24.1%), and amiodarone (21.7%) were the most common global choices of first‐line rhythm control, and amiodarone or sotalol were the preferred second‐line rhythm control agents, 1 exception being Central/South America. Conclusions: These results highlight points of divergence from the American College of Cardiology (ACC)/ American Heart Association (AHA)/European Society of Cardiology (ESC) guidelines for the management of AF in terms of first‐line drug selection in patients with associated SHD or coronary artery disease. Copyright © 2010 Wiley Periodicals, Inc.