Regional Lack of Consistency in the Management of Atrial Fibrillation (From the RecordAF Trial)

Abstract American and European society guidelines for atrial fibrillation (AF) management mostly agree on the utilization of rate and rhythm control strategies as well as the indications for oral anticoagulant (OAC) use. However, the level of adherence to guidelines in clinical practice may vary by...

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Bibliographic Details
Published in:The American journal of cardiology 2017-01, Vol.119 (1), p.47-51
Main Authors: Darrat, Yousef H., MD, Shah, Jignesh, MD, MPH, Elayi, Claude-Samy, MD, Morales, Gustavo X., MD, Naditch-Brûlé, Lisa, MD, Brette, Sandrine, Taniou, Christine, Kowey, Peter R., MD, Schwartz, Peter J., MD
Format: Article
Language:English
Subjects:
Aged
Anti-Arrhythmia Agents - therapeutic use
Anticoagulants
Anticoagulants - therapeutic use
Atrial Fibrillation - drug therapy
Atrial Fibrillation - epidemiology
Cardiac arrhythmia
Cardiovascular
Clinical outcomes
Costs
Disease
Europe - epidemiology
Female
Guideline Adherence
Heart attacks
Hospitalization
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
North America - epidemiology
Practice Guidelines as Topic
Prospective Studies
Registries
Risk Assessment
Stroke
Treatment Outcome
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Summary:Abstract American and European society guidelines for atrial fibrillation (AF) management mostly agree on the utilization of rate and rhythm control strategies as well as the indications for oral anticoagulant (OAC) use. However, the level of adherence to guidelines in clinical practice may vary by region. In this study, data analysis from RECORDAF, an international registry in patients with newly diagnosed AF of less than 1 year, shows that differences in practice exist between three regions, namely Western Europe (WE), Eastern Europe (EE) and North America (NA). Data analysed included major cardiovascular outcomes at 12 months, choice of rhythm versus rate control strategy and the use of OAC according to CHADS2 score between regions as well as the cost incurred according to management strategy. In conclusion, there is preference for rhythm control strategy in Europe compared to NA without a significant impact on major cardiovascular outcomes, there is significant discrepancy in the use of OAC in EE compared to the 2 other regions and rate control was found to be more costly in all regions.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2016.09.009