title: Atrial fibrillation management, outcomes and predictors of stable disease in daily practice: prospective non-interventional study.
abstract: BACKGROUND
  We aimed to describe the current management of patients with atrial fibrillation (AF) by cardiologists, and to identify predicting factors for a stable disease course.
  
  
  METHODS
  2753 consecutive patients with ECG-confirmed AF in the previous 12 months were documented in a 1-year observational (non-interventional) study from 616 centers. Stable disease was defined as having neither AF related intervention nor change in antiarrhythmic therapy in the previous 12 months. Stepwise selection of parameters for multivariate regression was used to identify factors for stable AF.
  
  
  RESULTS
  At baseline, paroxysmal AF was reported in 33.5%, persistent in 26.7%, and permanent in 39.7%; rate control alone was the prevailing antiarrhythmic strategy (64.2%). Drugs for thromboembolic prevention were administered in 93.8%, with a clear predominance of oral anticoagulants (OAC), alone or in combination with antiplatelet drugs. Electrical or pharmacological conversions were reported in 23.6%. A total of 96 (3.5%) patients in the total cohort experienced stroke, 72 patients (2.6%) TIA, and 24 (0.9%) arterial embolism. 26% were hospitalized during follow-up (0.4 events per patient), and 9.4% developed incident heart failure (42% prevalence at follow-up). The rate of stable patients was 43.4%. In the multivariate model male gender, history of stroke, and permanent (vs. persistent) AF were associated with stable disease. Conversely, the factors chronic heart failure, impaired left ventricular function, rhythm-control (vs. other), OAC and antiplatelet therapy were significantly correlated with unstable disease.
  
  
  CONCLUSIONS
  The relatively low proportion of stable patients and in particular, the high hospitalization and stroke rate indicate difficulties in everyday management of patients with AF.
authors.affiliation: Kardiologische Praxis Asperger Str, Ludwigsburg, Germany. ralph.bosch@kardio-praxis-lb.de
authors.forename: Ralph F
authors.initials: RF
authors.lastname: Bosch
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Kirch
authors.forename: Juergen-Detlef
authors.initials: JD
authors.lastname: Theuer
authors.forename: David
authors.initials: D
authors.lastname: Pittrow
authors.forename: Annette
authors.initials: A
authors.lastname: Kohlhaußen
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bonnemeier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents