European Heart Journal Advance Access originally published online on October 4, 2005
European Heart Journal 2005 26(22):2422-2434; doi:10.1093/eurheartj/ehi505
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Atrial fibrillation management: a prospective survey in ESC Member Countries
The Euro Heart Survey on Atrial Fibrillation
1Department of Cardiology, University Hospital Maastricht, P. Debyelaan 25, PO Box 5800, Maastricht 6202AZ, Maastricht, The Netherlands
2Department of Cardiology, Guglielmo da Saliceto Hospital, Piacenza, Italy
3Department of Cardiology, St George's Hospital, London, UK
4Department of Cardiology, University Hospital Lund, Lund, Sweden
5Department of Cardiology, Krankenhaus am Urban, Berlin, Germany
6Department of Cardiology, St Mary's Hospital, London, UK
7Department of Medical Cardiology, Royal Infirmary, Glasgow, UK
8Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany
9Department of Cardiology, Hopital European Georges Pompidou, Paris, France
10Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands
11Division of Cardiology, Centre Hospitalier Universitaire Nord, Marseille, France
Received 30 March 2005; revised 26 August 2005; accepted 2 September 2005; online publish-ahead-of-print 4 October 2005.
* Corresponding author. Tel: +31 433875350; fax: +31 433875104.E-mail address: r.nieuwlaat{at}cardio.azm.nl
See page 2356 for the editorial comment on this article (doi:10.1093/eurheartj/ehi489)
Aims To describe atrial fibrillation (AF) management in member countries of the European Society of Cardiology (ESC) and to verify cardiology practices against guidelines.
Methods and results Among 182 hospitals in 35 countries, 5333 ambulant and hospitalized AF patients were enrolled, in 2003 and 2004. AF was primary or secondary diagnosis, and was confirmed on ECG in the preceding 12 months. Clinical type of AF was reported to be first detected in 978, paroxysmal in 1517, persistent in 1167, and permanent in 1547 patients. Concomitant diseases were present in 90% of all patients, causing risk factors for stroke to be also highly prevalent (86%). As many as 69% of patients were symptomatic at the time of the survey; among asymptomatic patients, 54% were previously experienced symptoms. Oral anticoagulation was prescribed in 67 and 49% of eligible and ineligible patients, respectively. A rhythm control strategy was applied in 67% of currently symptomatic patients and in 44% of patients who never experienced symptoms.
Conclusion This survey provides a unique snapshot of current AF management in ESC member countries. Discordance between guidelines and practice was found regarding several issues on stroke prevention and antiarrhythmic therapy.
Key Words: Atrial fibrillation • Heart failure • Guidelines • Anticoagulation • Rhythm control • Rate control
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- The Euro Heart Survey on atrial fibrillation: a picture and a thousand words
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