Treatment strategy and clinical outcome in Japanese patients with atrial fibrillation.
Many large-scale randomized control trials (RCTs) have been performed regarding treatment strategy in atrial fibrillation (AF) in Western countries and also in Japan. However, limited data are available concerning real-world relationships between the treatment strategy and prognosis of AF patients. Out of a prospective cohort of The Shinken Database 2004 (n = 2 412), 286 AF patients (male 205, 64.1 +/- 12.3 years, paroxysmal form 165) were retrospectively investigated. The percentage of AF patients under the rhythm control strategy was evaluated using the Kaplan-Meier method, which showed the cumulative proportion of rhythm control strategy was approximately 30% at the 90th day after the initial visit and 40.0% at 1 year. The average time to the first rhythm control strategy was 68.3 +/- 106.7 days. Those under rhythm control strategy were associated with fewer coexisting organic cardiac diseases, a younger age, and smaller left atrial dimension. Consequently, they showed very good prognosis (cumulative incidence rate of cardiovascular events at 1 year was 0.0%). Careful induction of rhythm control strategy, which was adopted in approximately 40% of the patients in the real world, was associated with fewer comorbidities and therefore might lead to better prognosis, although this does not mean the direct effects of rhythm control strategy.
Suzuki
Shinya
S
Department of Clinical Epidemiology & Systems, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. sinsuz-tky@umin.ac.jp
Yamashita
Takeshi
T
Otsuka
Takayuki
T
Sagara
Koichi
K
Uejima
Tokuhisa
T
Oikawa
Yuji
Y
Yajima
Junji
J
Koike
Akira
A
Nagashima
Kazuyuki
K
Kirigaya
Hajime
H
Ogasawara
Ken
K
Sawada
Hitoshi
H
Yamazaki
Tsutomu
T
Aizawa
Tadanori
T
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D001281:Atrial Fibrillation / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D015897:Comorbidity; D019992:Databases as Topic; D004554:Electric Countershock / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006760:Hospitalization; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents