title: [The Mexican Registry of Atrial Fibrillation (ReMeFa)].
abstract: BACKGROUND
  The Mexican Registry of Atrial Fibrillation (ReMeFa) is the first national multicenter registry with one-year clinical follow-up on the treatment of atrial fibrillation (AF) in newly diagnosed patients.
  
  
  OBJECTIVE
  To describe the demographics and treatment modalities for rhythm control (RC) strategy or heart rate (HR) control in patients with AF treated by cardiologists. A secondary objective was to prospectively evaluate the status of AF according to the chosen strategy; sinus rhythm in RC and mean ventricular rate at rest ≤ 80 bpm in HR, as well as the incidence of clinical outcomes at 12 month follow-up.
  
  
  METHODS
  ReMeFa was a multicenter, prospective, descriptive study. We included adults with documented AF. We excluded those with AF secondary to reversible causes, undergoing pulmonary vein ablation, pacemaker or defibrillator users, with a life expectancy of less than one year, or with physical or mental impediments to meet the protocol objectives. Data were collected at baseline and at 6 and 12 months.
  
  
  RESULTS
  We registered 1,201 subjects and 1,193 were eligible for evaluation: 40% were on RC strategy and 60% on HR control. In the RC strategy, the drugs most commonly used were class III antiarrhythmics (64%), beta-blockers (25%), and digoxin (24%). In HR control strategy, the drugs used were digoxin (69%), class III antiarrhythmics (59%), and beta-blockers (56%). Compared with those on HR control, patients in RC strategy were younger (64 ± 14 years), in sinus rhythm (55%) and with paroxysmal AF (60%) at baseline. Patients in HR control were older (68 ± 13 years), with non-paroxysmal AF (91%), valvular disease (42%), heart failure (35%), left ventricular dysfunction (33%), and diabetes (25%). At one year follow-up, a 3% incidence of ischemic stroke was observed in the HR control group, significantly higher than the 1% observed in the RC strategy (p = 0.041).
  
  
  CONCLUSIONS
  ReMeFa registry results offer a current and comprehensive perspective on management strategies in Mexican patients with AF. The RC strategy provided better control of the arrhythmia as compared with the HR control strategy and it was associated with a lower rate of ischemic stroke. Nonetheless, current strategies of treatment of AF are not satisfactory.
authors: Unidad Médica de Alta Especialidad T-1, Instituto Mexicano del Seguro Social, León, Gto.
authors: Susano
authors: S
authors: Lara-Vaca
authors: Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jal.
authors: Alejandro
authors: A
authors: Cordero-Cabra
authors: Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F.
authors: Enrique
authors: E
authors: Martínez-Flores
authors: Departamento de Electrocardiología, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
authors: Pedro
authors: P
authors: Iturralde-Torres