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Issue III registry defines best syncope candidates for cardiac pacing
Date:6/26/2013

Between January 2012 and January 2013 the PREvention oF thromboembolic events European Registry in Atrial Fibrillation (PREFER) registry enrolled consecutive patients with AF from 461 centres in France, Germany, Italy, Spain and UK. Altogether 42% of patients were office based, 53% hospital based and 89% were treated by cardiologists. "Since practice patterns can be influenced by the type of physicians, we felt it was important to recruit patients from a number of different settings," explained Prof. Kirchhof.

Results showed that of the 7,243 evaluable patients enrolled, 30% had paroxysmal AF, 24% persistent AF, 7.2% long standing persistent, and 38.8% had permanent AF.

When medications were examined it was found that 66.3% of patients (4799) received a vitamin K antagonist (VKA) as monotherapy; 9.9% of patients (720) received VKA and an antiplatelet agents in combination; and 6.1% received novel oral anticoagulants (dabigatran, rivaroxaban or apixaban). Furthermore, antiplatelet agents alone were given to 11.2% of patients (808) and 6.5% of patients (474) received no antithrombotic therapy at all.

Altogether 78.6% of patients were adequately rate controlled, using a mean heart rate of 60 to 100 bpm as the definition.

Rhythm control therapy was given to 66.7 % of patients, with rhythm control consisting of electrical cardioversion in 18.1 % of patients; pharmacological conversion in 19.5%; amiodarone in 24.1%; flecainide in 10.5%; sotalol in 5.5%; dronedarone in 4% and other antiarrhythmic drugs in 3.1% and catheter ablation in 5%. However, over 80% of patients still suffered from AF symptoms despite good rate control.

"We were surprised and puzzled by the high number of patients who suffer from AF despite good rate control," said Prof. Kirchhof. "This indicates that we have more work to do to develop tools to better prevent AF and possibly to better maintain sinus rhythm in the future."

The ongoing EAST (Early
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Contact: Jacqueline Partarrieu
press@escardio.org
33-622-418-492
European Society of Cardiology
Source:Eurekalert

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