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European Heart Journal Advance Access published online on October 4, 2005

European Heart Journal, doi:10.1093/eurheartj/ehi505
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received March 30, 2005
Revised August 26, 2005
Accepted September 2, 2005

Clinical research

Atrial fibrillation management: a prospective survey in ESC Member Countries

The Euro Heart Survey on Atrial Fibrillation

Robby Nieuwlaat 1*, Alessandro Capucci 2, A. John Camm 3, S. Bertil Olsson 4, Dietrich Andresen 5, D. Wyn Davies 6, Stuart Cobbe 7, Günter Breithardt 8, Jean-Yves Le Heuzey 9, Martin H. Prins 10, Samuel Lévy 11, Harry J.G.M. Crijns 1, and on behalf of the Euro Heart Survey Investigators

1 Department of Cardiology, University Hospital Maastricht, P. Debyelaan 25, PO Box 5800, Maastricht 6202AZ, Maastricht, The Netherlands
2 Department of Cardiology, Guglielmo da Saliceto Hospital, Piacenza, Italy
3 Department of Cardiology, St George's Hospital, London, UK
4 Department of Cardiology, University Hospital Lund, Lund, Sweden
5 Department of Cardiology, Krankenhaus am Urban, Berlin, Germany
6 Department of Cardiology, St Mary's Hospital, London, UK
7 Department of Medical Cardiology, Royal Infirmary, Glasgow, UK
8 Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany
9 Department of Cardiology, Hopital European Georges Pompidou, Paris, France
10 Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands
11 Division of Cardiology, Centre Hospitalier Universitaire Nord, Marseille, France

* To whom correspondence should be addressed.
Robby Nieuwlaat, E-mail: r.nieuwlaat{at}cardio.azm.nl


   Abstract

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.

Keywords: Atrial fibrillation; Heart failure; Guidelines; Anticoagulation; Rhythm control; Rate control.
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