title: Baseline characteristics and management of patients with atrial fibrillation/flutter in the emergency department: results of a prospective, multicentre registry in China.
abstract: OBJECTIVE
  There have been several studies of atrial fibrillation (AF) over the past decades; however, data from Chinese patients are scarce. The aim of the study was therefore to describe the patient characteristics, risk profile and management strategies for Chinese AF patients presenting to emergency department (ED).
  
  
  METHODS
  We conducted a prospective, multicentre registry of patients with AF or atrial flutter (AFL) in China. Participants were enrolled at 20 EDs, then data regarding baseline characteristics and treatment in EDs were collected.
  
  
  RESULTS
  Of the 2016 Chinese patients, 1104 (54.8%) were female. Six hundred eighteen (30.7%) had paroxysmal AF, 452 (22.4%) had persistent AF and 945 (46.9%) had permanent AF. The most common comorbidity was hypertension (55.5%), followed by coronary artery disease (41.8%) and heart failure (HF, 37.4%). The prevalence of concomitant cardiovascular risk factors, such as HF and valvular heart disease, increased as AF progressed. Among the patients with non-valvular AF, 110 (12.7%) of those with CHADS2 (congestive HF, hypertension, age of 75 years and greater, diabetes mellitus and history of stroke) ≥2 were prescribed oral anticoagulants (OAC), while 119 (15.6%) of those with CHADS2 <2 received such agents. Among the 324 patients with valvular AF, 134 (41.4%) actually were treated with OAC. The international normalised ratio value was within the target range (2.0-3.0) in 96 patients only (26.4%). Moreover, a total of 16.2% of the patients received ≥1 anti-arrhythmic agents, whereas rate control agents were used more frequently (68.4%).
  
  
  CONCLUSIONS
  According to the present study, the risk profile and management of Chinese patients with AF/AFL differed from that observed in previous studies. The use of OAC inadequately deviate from current guidelines.
authors.affiliation: The Emergency and Intensive Care Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.forename: J
authors.initials: J
authors.lastname: Zhu
authors.forename: X
authors.initials: X
authors.lastname: Shao
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.forename: L
authors.initials: L
authors.lastname: Zhao
authors.forename: P
authors.initials: P
authors.lastname: Yu
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: Q
authors.initials: Q
authors.lastname: He
authors.forename: X
authors.initials: X
authors.lastname: Gu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000628:therapy; D001282:Atrial Flutter / Q000453:epidemiology / Q000628:therapy; D058406:Cardiac Resynchronization Therapy / Q000379:methods; D002681:China / Q000453:epidemiology; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment / Q000379:methods; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: CHADS2 score; anti-arrhythmic agent; anticoagulation; atrial fibrillation; risk factor