Background: The Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation (Record AF) study is the first worldwide, prospective, survey of real-life management of atrial fibrillation (AF) in recently diagnosed patients (n=5604) with a 1-year follow-up. Hypothesis: Surveys of AF management have identified a divergence between guidelines and clinical practice, and an overinterpretation of guidelines in low-risk patients. Methods: Physicians' theoretical approaches to rhythm and rate control were investigated using a pre-study questionnaire. Results: One cardiologist, from each of the 583 sites in 6 regions, completed a questionnaire on their practice andmanagement of AF patients. In AF patients with structural heart disease (SHD), amiodarone was the most frequent choice of first-line rhythm control agents in all regions. Amiodarone or sotalol tended to be the preferred second-line rhythm control agents, 1 exception being Central/South America. β-Blockers were the first-line rate control agents for patients with AF and SHD in all regions, and calcium channel blockers and cardiac glycosides were the most common second-line rate control treatments in all regions, except Asia. In lone AF patients, propafenone (30.6%), flecainide (24.1%), and amiodarone (21.7%) were the most common global choices of first-line rhythm control, and amiodarone or sotalol were the preferred second-line rhythm control agents, 1 exception being Central/South America. Conclusions: These results highlight points of divergence from the American College of Cardiology (ACC)/American Heart Association (AHA)/European Society of Cardiology (ESC) guidelines for the management of AF in terms of first-line drug selection in patientswith associated SHD or coronary artery disease.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine