Dąbrowski Rafał, Opolski Grzegorz, Włodarczyk Piotr, Kiliszek Marek, Ponikowski Piotr
Instytut Kardiologii, Warszawa.
Kardiol Pol. 2014;72(8):700-6. doi: 10.5603/KP.a2014.0067. Epub 2014 Mar 27.
Cardioversion of atrial fibrillation (AF) and maintenance of sinus rhythm are the basic strategies of treating AF patients. Precise data regarding the current practice of AF cardioversion in Europe in clinical practice is lacking.
The primary objective of this prospective observational study was to characterise patients and treatment patterns in whom cardioversion was the planned therapeutic option.
Patients with recent onset of AF were included, regardless of when the timing of the cardioversion was planned. Ten countries participated in the study, with Poland contributing 501 patients. The global enrollment period lasted from May 2010 to June 2011. Follow-up data was collected 60 days after enrollment via a medical chart abstraction or a telephone interview.
The average age of the Polish patient population was 64.2 years, and 38.5% of patients were female. Mean duration of arrhythmia was 3.3 years. Paroxysmal AF was diagnosed in 38.3% and persistent AF in 43.6% of patients. The most prevalent AF risk factors were hypertension (75.0%), diabetes mellitus (20.5%), and family history of AF (12.1%). Mean body mass index of study patients was 29.5 kg/m². The most pertinent factors triggering AF were emotion (12.4%), exercise (6.5%), electrolyte disturbances (5.5%), and acute myocardial infarction (3.7%). Only 14.2% of patients were asymptomatic. Previous episodes of AF were present in 83.1% of patients and 58.5% of them had previous cardioversion: 49.8% pharmacological and 50.2% electrical. The most often used anti-arrhythmic drugs were amiodarone (53.4%) and propafenone (32.2%). The rate of antithrombotic treatment was low: 59.6%. Finally electrical cardioversion had been undergone by 165 (53%) patients and pharmacological by 146 (47%) patients.
The population of patients with AF and planned cardioversion represented typical patients with non-valvular AF and standard symptoms, the vast majority of whom were symptomatic. The study group in terms of comprehensive characteristics is representative of the general population of AF patients.
心房颤动（AF）的复律和窦性心律的维持是治疗AF患者的基本策略。目前欧洲临床实践中AF复律的精确数据尚缺乏。
这项前瞻性观察性研究的主要目的是描述计划采用复律作为治疗选择的患者及其治疗模式。
纳入近期发作AF的患者，无论计划何时进行复律。10个国家参与了该研究，波兰贡献了501例患者。全球入组期从2010年5月持续至2011年6月。入组60天后通过病历摘要或电话访谈收集随访数据。
波兰患者人群的平均年龄为64.2岁，38.5%为女性。心律失常的平均持续时间为3.3年。38.3%的患者诊断为阵发性AF，43.6%为持续性AF。最常见的AF危险因素为高血压（75.0%）、糖尿病（20.5%）和AF家族史（12.1%）。研究患者的平均体重指数为29.5kg/m²。引发AF最相关的因素为情绪（12.4%）、运动（6.5%）、电解质紊乱（5.5%）和急性心肌梗死（3.7%）。仅14.2%的患者无症状。83.1%的患者既往有AF发作，其中58.5%曾进行过复律：49.8%为药物复律，50.2%为电复律。最常用的抗心律失常药物为胺碘酮（53.4%）和普罗帕酮（32.2%）。抗栓治疗率较低：59.6%。最后，165例（53%）患者接受了电复律，146例（47%）患者接受了药物复律。
计划进行复律的AF患者群体代表了具有典型症状的非瓣膜性AF患者，其中绝大多数有症状。就综合特征而言，该研究组代表了AF患者的总体人群。
