title: Management of patients with atrial fibrillation by primary-care physicians in Germany: 1-year results of the ATRIUM registry.
abstract: BACKGROUND
  Patients with atrial fibrillation (AF) in Germany are often managed jointly by primary-care physicians in cooperation with cardiologists. We aimed to investigate the management and 1-year outcomes of AF patients in this setting.
  
  
  OBJECTIVE
  We set out to describe the current management of AF patients in primary care settings in Germany.
  
  
  METHODS
  Observational registry with 1-year follow-up, performed by a representative, randomly selected sample of 781 primary-care physicians in Germany.
  
  
  RESULTS
  Of 3781 patients with electrocardiographically documented AF, 3163 patients (age 71.9 ± 9.2 years, 57.9% males) were followed for 1 year; 28.4% had paroxysmal, 27.0% persistent, and 43.3% permanent AF. Comorbid conditions were common (mean CHA2 DS2-VASc score 3. 8 ± 1.7). Rhythm-control therapy was used in 16.4%. Although oral anticoagulation was often used (82.7% at baseline), stroke rate during follow-up was high (2.7% stroke, 3.0% transient ischemic attack). Despite a long duration of AF (mean duration 61 months at enrollment), 18.5% of patients were hospitalized during the 1-year follow-up.
  
  
  CONCLUSIONS
  In this unselected group of patients with long-standing AF managed in primary care, hospitalizations and cardiovascular complications including strokes are frequent, illustrating the need to improve management of AF patients.
authors.affiliation: University of Birmingham Centre of Cardiovascular Sciences and SWBH NHS Trust, Birmingham, United Kingdom, and Department of Cardiology and Angiology, University of Münster, Münster, Germany; German Atrial Fibrillation competence NETwork, Münster, Germany.
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
authors.forename: Janine
authors.initials: J
authors.lastname: Schmalowsky
authors.forename: David
authors.initials: D
authors.lastname: Pittrow
authors.forename: Ludger
authors.initials: L
authors.lastname: Rosin
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Kirch
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants