Document Detail


Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey.
MedLine Citation:
PMID:  20235224     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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. beta-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.
Authors:
Peter R Kowey; Günter Breithardt; John Camm; Harry Crijns; Paul Dorian; Jean-Yves Le Heuzey; Laurence Pedrazzini; Eric N Prystowsky; Geneviève Salette; Peter J Schwartz; Christian Torp-Pedersen; William Weintraub
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  33     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  172-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Wiley Periodicals, Inc.
Affiliation:
Lankenau Hospital, 100 Lancaster Avenue, Wynnewood, PA, USA. koweyp@mlhs.org
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