Antonelli Dante, Peres Dimitry, Turgeman Yoav
Department of Cardiology, HaEmek Medical Center, Afula, Israel.
Isr Med Assoc J. 2012 May;14(5):290-3.
Information on the prevalence and real-life management of atrial fibrillation (AF) in a general practice setting is sparse.
To investigate the prevalence, clinical features and real-life management of AF in ambulatory consultant cardiology clinics.
We studied consecutive new patients with a diagnosis of AF. Recorded data included demographics, comorbidities and prescribed drugs. Antithrombotic therapy was chosen according to CHADS2 score in non-rheumatic valve AF patients; for AF patients with rheumatic valve disease warfarin treatment was prescribed. The data were compared with data of patients without AF admitted to the ambulatory cardiology clinics during the same period.
The study included 865 patients whose mean age was 64.9 +/- 7.1 years. AF was reported in 137 patients (15.8%); 81 were women (59%) and the mean age was 74.4 +/- 7.5 years. Heart rate rhythm-control strategy was applied in 41 patients (45%) and rate control in 50 patients (55%) with paroxysmal or persistent AF. Rate-control strategy was used in all patients with permanent AF. In most patients AF was associated with one or more concomitant comorbidities, most frequently hypertension. Warfarin was prescribed in 98 patients with AF (71.5%), aspirin in 57 patients with AF (41.6%), and both drugs in 18 patients with AF. Amiodarone was used in 24 patients with AF (17.5%); beta blockers were used in 95 patients with AF (69.3%) and 377 patients without AF (51.8%).
We provide a snapshot of real-life contemporary daily clinical practice and evaluate AF burden and therapy. Most patients were found to have AF associated with one or more concomitant comorbidity.
关于基层医疗环境中心房颤动（AF）的患病率及实际管理的信息匮乏。
调查门诊心脏病专家诊所中AF的患病率、临床特征及实际管理情况。
我们研究了连续诊断为AF的新患者。记录的数据包括人口统计学信息、合并症及处方药物。非风湿性瓣膜性AF患者根据CHADS2评分选择抗栓治疗；对于风湿性瓣膜病AF患者，给予华法林治疗。将这些数据与同期门诊心脏病诊所中无AF患者的数据进行比较。
该研究纳入了865例患者，平均年龄为64.9±7.1岁。137例患者（15.8%）报告患有AF；81例为女性（59%），平均年龄为74.4±7.5岁。41例阵发性或持续性AF患者（45%）采用了心率节律控制策略，50例患者（55%）采用了心率控制策略。所有永久性AF患者均采用心率控制策略。大多数患者的AF与一种或多种合并症相关，最常见的是高血压。98例AF患者（71.5%）使用了华法林，57例AF患者（41.6%）使用了阿司匹林，18例AF患者同时使用了这两种药物。24例AF患者（17.5%）使用了胺碘酮；95例AF患者（69.3%）使用了β受体阻滞剂，377例无AF患者（51.8%）使用了β受体阻滞剂。
我们提供了当代日常临床实践的概况，并评估了AF负担及治疗情况。发现大多数患者的AF与一种或多种合并症相关。
