Mashal Abdallah, Katz Amos, Shvartzman Pesach
Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Isr Med Assoc J. 2011 Nov;13(11):666-71.
Atrial fibrillation (AF) is the most common arrhythmia in adults and is associated with increased mortality and morbidity.
To characterize patients diagnosed with AF in primary care clinics in southern Israel.
We conducted a cross-sectional study in 14 primary care clinics of the largest health insurance fund in Israel, reviewing the electronic medical records of adults aged > or = 25 years diagnosed with AF. The prevalence, evaluation, antithrombotic treatment and treatments for rate control/rhythm control were analyzed.
We retrieved the records of 995 patients with a diagnosis of AF; the prevalence of AF was 1.5% (2.5% aged > or = 45 years). The patients' mean age was 73.5 +/- 1.4 years and 55.3% were female. Vitamin K antagonist (VKA) was prescribed for 591 patients (59%), of whom 8.5% had no international normalized ratio follow-up tests for at least 3 months before our review. Among patients in the VKA treatment group the risk for thromboembolic events was considered to be high, moderate and low in 22% (n=131), 66% (n=391) and 12% (n=69), respectively. Patients with a low Congestive Hypertension Age Diabetes Stroke (CHADS2) score (odds ratio = 0.555, 95% confidence interval 0.357-0.862) and patients who did not receive VKA (OR = 0.601, 95% CI 0.459-0.787) received significantly less rate-control treatment. Of the patients with a low CHADS2 score (< 1) 52.7% received VKA treatment, and 39.4% with a high CHADS2 score (> or = 3) did not receive VKA. A positive correlation was found between anticoagulation and rate or rhythm control.
The prevalence and age distribution of AF in southern Israel are similar to findings in the western world. Many of the patients did not receive appropriate antithrombotic prophylaxis.
心房颤动（AF）是成年人中最常见的心律失常，与死亡率和发病率增加相关。
描述以色列南部基层医疗诊所中被诊断为AF的患者特征。
我们在以色列最大的健康保险基金的14家基层医疗诊所进行了一项横断面研究，回顾年龄≥25岁被诊断为AF的成年人的电子病历。分析患病率、评估、抗血栓治疗以及心率控制/节律控制治疗情况。
我们检索到995例诊断为AF的患者记录；AF患病率为1.5%（年龄≥45岁者为2.5%）。患者平均年龄为73.5±1.4岁，55.3%为女性。591例患者（59%）接受了维生素K拮抗剂（VKA）治疗，其中8.5%在我们回顾前至少3个月没有进行国际标准化比值随访检测。在VKA治疗组患者中，血栓栓塞事件风险分别被认为高、中、低的比例为22%（n = 131）、66%（n = 391）和12%（n = 69）。充血性心力衰竭、高血压、年龄、糖尿病、卒中（CHADS2）评分低的患者（比值比 = 0.555，95%置信区间0.357 - 0.862）以及未接受VKA治疗的患者（OR = 0.601，95% CI 0.459 - 0.787）接受心率控制治疗明显较少。CHADS2评分低（<1）的患者中有52.7%接受VKA治疗，CHADS2评分高（≥3）的患者中有39.4%未接受VKA治疗。抗凝与心率或节律控制之间存在正相关。
以色列南部AF的患病率和年龄分布与西方世界的研究结果相似。许多患者未接受适当的抗血栓预防治疗。
