Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year:: follow-up of the Euro Heart Survey on Atrial Fibrillation

被引:222
作者
Nieuwlaat, Robby [1 ]
Prins, Martin H. [2 ]
Le Heuzey, Jean-Yves [3 ]
Vardas, Panos E. [4 ]
Aliot, Etienne [5 ]
Santini, Massimo [6 ]
Cobbe, Stuart M. [7 ]
Widdershoven, Jos W. M. G. [8 ]
Baur, Leo H. [9 ]
Levy, Samuel [10 ]
Crijns, Harry J. G. M. [1 ]
机构
[1] Univ Hosp Maastricht, Dept Cardiol, Maastricht, Netherlands
[2] Univ Hosp Maastricht, Dept Clin Epidemiol & Med Technol Assessment, Maastricht, Netherlands
[3] Hop Europeen Georges Pompidou, Dept Cardiol, Paris, France
[4] Univ Hosp, Dept Cardiol, Iraklion, Crete, Greece
[5] Univ Hosp Nancy, Dept Cardiol, Nancy, France
[6] San Filippo Neri Hosp, Dept Cardiol, Rome, Italy
[7] Royal Infirm, Dept Med Cardiol, Glasgow G31 2ER, Lanark, Scotland
[8] TweeSteden Ziekenhuis, Dept Cardiol, Tilburg, Netherlands
[9] Atrium Med Ctr, Dept Cardiol, Heerlen, Netherlands
[10] Ctr Hosp Univ Nord, Div Cardiol, Marseille, France
关键词
atrial fibrillation; mortality; prognosis; progression; management; anticoagulation; rhythm control; rate control;
D O I
10.1093/eurheartj/ehn139
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims To gain insight in the prognosis and treatment of atrial fibrillation (AF) patients during 1-year follow-up in the Euro Heart Survey (EHS) on AF. Methods and results The EHS enrolled 5333 AF patients in 2003-2004. One-year follow-up data were available for 80%. Of first detected AF patients, 46% did not have a recurrence during 1 year, paroxysmal AF largely remained paroxysmal AF (80%), and 30% of persistent AF progressed to permanent AF. Many treatment changes occurred since baseline. Oral anticoagulation was started in 19% and discontinued in 16% of all patients. Of patients initially on rhythm control 27% did not receive rhythm control during follow-up, whereas 15% of patients initially on rate control received rhythm control. Mortality was highest in permanent AF (8.2%), but also substantial in first detected AF (5.7%). In multivariable analysis, sinus rhythm at baseline was associated with lower mortality, but no significant effect was observed regarding the application of either rhythm or rate control. Conclusion The EHS on AF provides unique prospective observational data on AF progression, long-term treatment, prognosis, and determinants of adverse outcome of the total clinical spectrum of AF in a European cardiology-based patient cohort.
引用
收藏
页码:1181 / 1189
页数:9
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