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Europace. 2014 Jan;16(1):6-14. doi: 10.1093/europace/eut263. Epub 2013 Oct 1.

Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events--European Registry in Atrial Fibrillation (PREFER in AF).

Author information

1
University of Birmingham Centre for Cardiovascular Sciences and SWBH NHS Trust, City Hospital, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, Institute of Biomedical Research IBR 136, Birmingham B15 2TT, UK.

Abstract

AIMS:

We sought to describe the management of patients with atrial fibrillation (AF) in Europe after the release of the 2010 AF Guidelines of the European Society of Cardiology.

METHODS AND RESULTS:

The PREFER in AF registry enrolled consecutive patients with AF from January 2012 to January 2013 in 461 centres in seven European countries. Seven thousand two hundred and forty-three evaluable patients were enrolled, aged 71.5 ± 11 years, 60.1% male, CHA2DS2VASc score 3.4 ± 1.8 (mean ± standard deviation). Thirty per cent patients had paroxysmal, 24.0% had persistent, 7.2% had long-standing persistent, and 38.8% had permanent AF. Oral anticoagulation was used in the majority of patients: 4799 patients (66.3%) received a vitamin K antagonist (VKA) as mono-therapy, 720 patients a combination of VKA and antiplatelet agents (9.9%), 442 patients (6.1%) a new oral anticoagulant drugs (NOAC). Antiplatelet agents alone were given to 808 patients (11.2%), no antithrombotic therapy to 474 patients (6.5%). Of 7034 evaluable patients, 5530 (78.6%) patients were adequately rate controlled (mean heart rate 60-100 bpm). Half of the patients (50.7%) received rhythm control therapy by electrical cardioversion (18.1%), pharmacological cardioversion (19.5%), antiarrhythmic drugs (amiodarone 24.1%, flecainide or propafenone 13.5%, sotalol 5.5%, dronedarone 4.0%), and catheter ablation (5.0%).

CONCLUSION:

The management of AF patients in 2012 has adapted to recent evidence and guideline recommendations. Oral anticoagulant therapy with VKA (majority) or NOACs is given to over 80% of eligible patients, including those at risk for bleeding. Rate is often adequately controlled, and rhythm control therapy is widely used.

KEYWORDS:

Adherence to guidelines; Antiarrhythmic drugs; Anticoagulation; Atrial fibrillation; Catheter ablation; Guidelines; Management; Rate control; Registry; Rhythm control; Stroke

PMID:
24084680
PMCID:
PMC3864758
DOI:
10.1093/europace/eut263
[Indexed for MEDLINE]
Free PMC Article

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