title: Complexity of atrial fibrillation patients and management in Chinese ethnicity in routine daily practice: insights from the RealiseAF Taiwanese cohort.
abstract: BACKGROUND
  Most atrial fibrillation (AF) epidemiology described Western populations; there is a paucity of data from Chinese ethnicity. This study presented differences in patient characteristics and management strategies, and assessed the quality of life (QoL) and AF control in Taiwanese patients from RealiseAF.
  
  
  METHODS
  RealiseAF enrolled 10,523 patients internationally, in which Taiwanese cohort accounts for 7.1%. Physicians were randomly selected from a global list. Patient characteristics, management and therapeutic strategies of AF, QoL measured by the EQ-5D questionnaire, and the control of AF (in sinus rhythm, or AF with a ventricular rate ≤80 beats per minute) evaluated by electrocardiography were assessed.
  
  
  RESULTS
  Taiwanese patients were mostly outpatients (93.9%), older (70.2±11.8 years), accompanied by more comorbidities, more frequently (51.7%) in permanent AF, and symptomatic (European Heart Rhythm Association score ≥II: 81.5%) compared with the non-Taiwanese cohort. A rhythm-control strategy was less preferable to rate-control than in non-Taiwanese cohort as well as the use of class I and III antiarrhythmic drugs (AADs); 85.2% of Taiwanese patients received AADs, among which beta-blockers were the most common (46.9%). QoL was compromised (Visual Analogue Scale: 70.3±14.4; single index utility score: 0.81±0.25) and only 48.6% of the Taiwanese patients had AF controlled.
  
  
  CONCLUSIONS
  AF complexity in the Taiwanese cohort was similar to or even greater than that in the non-Taiwanese cohort. The Taiwanese patients were highly symptomatic; QoL was impaired despite the widespread use of medications and AF control was unsatisfactory. There is an apparent unmet need in AF treatment in Chinese ethnicity.
authors.affiliation: General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Kang-Ling
authors.initials: KL
authors.lastname: Wang
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Cheng-Hsueh
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tao-Cheng
authors.initials: TC
authors.lastname: Wu
authors.affiliation: Sanofi, Paris, France.
authors.forename: Lisa
authors.initials: L
authors.lastname: Naditch-Brûlé
authors.affiliation: INSERM U-698, Paris, France; Assistance Publique - Hôpitaux de Paris, Centre Hospitalier Bichat-Claude Bernard, Paris, France.
authors.forename: Philippe Gabriel
authors.initials: PG
authors.lastname: Steg
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.affiliation: General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: cechiang@vghtpe.gov.tw.
authors.forename: Chern-En
authors.initials: CE
authors.lastname: Chiang
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D044466:Asian People / Q000208:ethnology*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents
keywords: Antiarrhythmic drugs; Atrial fibrillation; Epidemiology; Quality of life