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Proportion of Patients with Implanted Permanent Pacemakers with Atrial Fibrillation Receiving Appropriate Medical Prophylaxis in North Wales
Author(s) -
JONES MATTHEW,
WILLIAMS EDGAR M.
Publication year - 2012
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2012.03430.x
Subject(s) - medicine , atrial fibrillation , stroke (engine) , warfarin , medical record , cardiology , medical prescription , concomitant , retrospective cohort study , rivaroxaban , mechanical engineering , engineering , pharmacology
Background :Atrial fibrillation (AF) is associated with an increased long‐term risk of stroke, heart failure, and mortality. Previous studies have demonstrated the suboptimal use of anticoagulation therapy in patients with AF.Methods :A retrospective survey of patients (N = 1,113) fitted with dual‐chamber pacemakers found 71 patients (age 69 ± 35, mean ± standard deviation) with atrial tachycardia and AF (defined as >5 minutes per day). Their medical records and anticoagulation status were investigated and used to stratify each patient for stroke risk with the Birmingham 2009 schema (CHA 2 DS 2 ‐VASc) and assessed to determine the rate of appropriate thromboembolism (TE) prophylaxis prescription.Results :The most common overall concomitant risk factor for stroke was hypertension (54%), followed by age ≥75 (51%), being female and previous stroke/transient ischemic attack/TE (39%). The average CHA 2 DS 2 ‐VASc score was 3.7 ± 1.6. Fifty‐six percent of the patients were not receiving appropriate anticoagulation therapy.Conclusion :This study demonstrates an underutilization of the oral anticoagulant warfarin in patients with known AF and that the clinicians may not be regarding current stroke risk factors when adopting a thromboprophylaxis strategy. (PACE 2012; 35:935–942)