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European Heart Journal Advance Access originally published online on April 7, 2008
European Heart Journal 2008 29(9):1181-1189; doi:10.1093/eurheartj/ehn139
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year: follow-up of the Euro Heart Survey on Atrial Fibrillation

Robby Nieuwlaat1,*, Martin H. Prins2, Jean-Yves Le Heuzey3, Panos E. Vardas4, Etienne Aliot5, Massimo Santini6, Stuart M. Cobbe7, Jos W.M.G. Widdershoven8, Leo H. Baur9, Samuel Lévy10 and Harry J.G.M. Crijns1

1 Department of Cardiology, University Hospital Maastricht, Maastricht, The Netherlands
2 Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands
3 Department of Cardiology, Hopital Europeen Georges Pompidou, Paris, France
4 Cardiology Department, University Hospital of Heraklion, Heraklion, Crete, Greece
5 Department of Cardiology, University Hospital Nancy, Nancy, France
6 Department of Cardiology, San Filippo Neri Hospital, Rome, Italy
7 Department of Medical Cardiology, Royal Infirmary, Glasgow, UK
8 Department of Cardiology, TweeSteden Ziekenhuis, Tilburg, The Netherlands
9 Department of Cardiology, Atrium Medical Centre, Heerlen, The Netherlands
10 Division of Cardiology, Centre Hospitalier Universitaire Nord, Marseille, France

Received 18 January 2007; revised 20 February 2008; accepted 13 March 2008; online publish-ahead-of-print 7 April 2008.

* Corresponding author. Tel: +31 43 3875053, Fax: +31 43 3875104, Email: nieuwlaatrobby{at}live.com.au

Aims: To gain insight in the prognosis and treatment of atrial fibrillation (AF) patients during 1-year follow-up in the Euro Heart Survey (EHS) on AF.

Methods and results: The EHS enrolled 5333 AF patients in 2003–2004. One-year follow-up data were available for 80%. Of first detected AF patients, 46% did not have a recurrence during 1 year, paroxysmal AF largely remained paroxysmal AF (80%), and 30% of persistent AF progressed to permanent AF. Many treatment changes occurred since baseline. Oral anticoagulation was started in 19% and discontinued in 16% of all patients. Of patients initially on rhythm control 27% did not receive rhythm control during follow-up, whereas 15% of patients initially on rate control received rhythm control. Mortality was highest in permanent AF (8.2%), but also substantial in first detected AF (5.7%). In multivariable analysis, sinus rhythm at baseline was associated with lower mortality, but no significant effect was observed regarding the application of either rhythm or rate control.

Conclusion: The EHS on AF provides unique prospective observational data on AF progression, long-term treatment, prognosis, and determinants of adverse outcome of the total clinical spectrum of AF in a European cardiology-based patient cohort.

Key Words: Atrial fibrillation • Mortality • Prognosis • Progression • Management • Anticoagulation • Rhythm control • Rate control


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