Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey

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

doi:http://dx.doi.org/10.1002/clc.20737

Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey

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

17 Citations (Scopus)

Abstract

Background: The Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation (Record AF) 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 andmanagement 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 patientswith associated SHD or coronary artery disease.

Original language	English
Journal	Clinical Cardiology
Volume	33
Issue number	3
Pages (from-to)	172-8
Number of pages	7
ISSN	0160-9289
DOIs	https://doi.org/10.1002/clc.20737
Publication status	Published - 1 Mar 2010

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Kowey, P. R., Breithardt, G., Camm, J., Crijns, H., Dorian, P., Le Heuzey, J-Y., Pedrazzini, L., Prystowsky, E. N., Salette, G., Schwartz, P. J., Torp-Pedersen, C., & Weintraub, W. (2010). Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey. Clinical Cardiology, 33(3), 172-8. https://doi.org/10.1002/clc.20737

Kowey, PR, Breithardt, G, Camm, J, Crijns, H, Dorian, P, Le Heuzey, J-Y, Pedrazzini, L, Prystowsky, EN, Salette, G, Schwartz, PJ, Torp-Pedersen, C & Weintraub, W 2010, 'Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey', Clinical Cardiology, vol. 33, no. 3, pp. 172-8. https://doi.org/10.1002/clc.20737

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title = "Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey",

abstract = "Background: The Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation (Record AF) 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 andmanagement 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 patientswith associated SHD or coronary artery disease.",

author = "Kowey, {Peter R} and G{\"u}nter Breithardt and John Camm and Harry Crijns and Paul Dorian and {Le Heuzey}, Jean-Yves and Laurence Pedrazzini and Prystowsky, {Eric N} and Genevi{\`e}ve Salette and Schwartz, {Peter J} and Christian Torp-Pedersen and William Weintraub",

year = "2010",

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doi = "http://dx.doi.org/10.1002/clc.20737",

language = "English",

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TY - JOUR

T1 - Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey

AU - Kowey, Peter R

AU - Breithardt, Günter

AU - Camm, John

AU - Crijns, Harry

AU - Dorian, Paul

AU - Le Heuzey, Jean-Yves

AU - Pedrazzini, Laurence

AU - Prystowsky, Eric N

AU - Salette, Geneviève

AU - Schwartz, Peter J

AU - Torp-Pedersen, Christian

AU - Weintraub, William

PY - 2010/3/1

Y1 - 2010/3/1

N2 - Background: The Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation (Record AF) 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 andmanagement 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 patientswith associated SHD or coronary artery disease.

AB - Background: The Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation (Record AF) 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 andmanagement 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 patientswith associated SHD or coronary artery disease.

U2 - http://dx.doi.org/10.1002/clc.20737

DO - http://dx.doi.org/10.1002/clc.20737

M3 - Journal article

SN - 0160-9289

VL - 33

SP - 172

EP - 178

JO - Clinical Cardiology

JF - Clinical Cardiology

IS - 3

ER -

Physician stated atrial fibrillation management in light of treatment guidelines: data from an international, observational prospective survey

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