Characteristics and management of outpatients with history of or current atrial fibrillation: the observational French EPHA study.
BACKGROUND
Limited French data are available for the different clinical types (paroxysmal, persistent and permanent) of atrial fibrillation and their comorbidities (AF).


OBJECTIVE
To provide contemporary insights into the characteristics and management of outpatients with a history of or current AF in France.


METHODS
EPHA is a national, observational, cross-sectional, multicentre descriptive study with retrospective data collection relating to the management, treatment and hospitalization of patients with AF.


RESULTS
One thousand three hundred and thirty-one patients (mean age: 74 +/- 11 years [55.7% > or =75 years]; 58.8% men) were included into the study between February 2009 and May 2009; their data were collected during the past 12 months. Of these, 38.2% had paroxysmal AF, 10.0% persistent AF and 51.8% permanent AF. Most patients had at least one cardiovascular risk factor (80.8%). Almost all patients (96.6%) had received an antiarrhythmic drug in the previous year, of which 59.6% received a rhythm control strategy (class I, class III) with or without rate control strategy (class II, class IV, digitalis) and 40.6% received a rate control strategy exclusively. Almost all (94.4%) patients were treated with an antithrombotic: 83.4% with a vitamin K antagonist and 21.9% with antiplatelet therapy. Almost one-fifth (18.4%) of patients had been hospitalized related to AF at least once in the previous year. Patients with paroxysmal and persistent AF were hospitalized more frequently (20.0% and 31.1%, respectively) than patients with permanent AF (14.8%).


CONCLUSIONS
About half of the patients had paroxysmal or persistent AF. Four-fifths of AF patients had at least one cardiovascular risk factor. The use of antiarrhythmic and antithrombotic treatments was very high. The rhythm control strategy was preferred in patients with paroxysmal or persistent AF.
Cohen
Ariel
A
Cardiology Department, Assistance publique-Hôpitaux de Paris and université Pierre-et-Marie-Curie, Saint-Antoine University and Medical School, 75571 Paris cedex 12, France. ariel.cohen@sat.aphp.fr
Dallongeville
Jean
J
Durand-Zaleski
Isabelle
I
Bouée
Stéphane
S
Le Heuzey
Jean-Yves
JY
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004554:Electric Countershock / Q000706:statistics & numerical data; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005602:France / Q000453:epidemiology; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000889:Anti-Arrhythmia Agents; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K