title: Atrial Fibrillation Management Strategies in Routine Clinical Practice: Insights from the International RealiseAF Survey.
abstract: BACKGROUND
  Atrial fibrillation (AF) can be managed with rhythm- or rate-control strategies. There are few data from routine clinical practice on the frequency with which each strategy is used and their correlates in terms of patients' clinical characteristics, AF control, and symptom burden.
  
  
  METHODS
  RealiseAF was an international, cross-sectional, observational survey of 11,198 patients with AF. The aim of this analysis was to describe patient profiles and symptoms according to the AF management strategy used. A multivariate logistic regression identified factors associated with AF management strategy at the end of the visit.
  
  
  RESULTS
  Among 10,497 eligible patients, 53.7% used a rate-control strategy, compared with 34.5% who used a rhythm-control strategy. In 11.8% of patients, no clear strategy was stated. The proportion of patients with AF-related symptoms (EHRA Class > = II) was 78.1% (n = 4396/5630) for those using a rate-control strategy vs. 67.8% for those using a rhythm-control strategy (p<0.001). Multivariate logistic regression analysis revealed that age <75 years or the paroxysmal or persistent form of AF favored the choice of a rhythm-control strategy. A change in strategy was infrequent, even in patients with European Heart Rhythm Association (EHRA) Class > = II.
  
  
  CONCLUSIONS
  In the RealiseAF routine clinical practice survey, rate control was more commonly used than rhythm control, and a change in strategy was uncommon, even in symptomatic patients. In almost 12% of patients, no clear strategy was stated. Physician awareness regarding optimal management strategies for AF may be improved.
authors.affiliation: General Clinical Research Center and Division of Cardiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chern-En
authors.initials: CE
authors.lastname: Chiang
authors.affiliation: Sanofi, Paris, France.
authors.forename: Lisa
authors.initials: L
authors.lastname: Naditch-Brûlé
authors.affiliation: Lincoln, Boulogne-Billancourt, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Brette
authors.affiliation: Department of Cardiology, Porto Medical School, Hospital São João, Porto, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Silva-Cardoso
authors.affiliation: University of Monastir and Cardiology A Department, FattoumaBourguiba University Hospital, Monastir, Tunisia-LR12SP16 Cardiothrombosis.
authors.forename: Habib
authors.initials: H
authors.lastname: Gamra
authors.affiliation: Department of Internal Medicine and Cardiology, Comenius University, Bratislava, Slovakia.
authors.forename: Jan
authors.initials: J
authors.lastname: Murin
authors.affiliation: Functional Diagnostics Department, National Medical Academy of Postgraduate Education, Kyiv, Ukraine.
authors.forename: Oleg J
authors.initials: OJ
authors.lastname: Zharinov
authors.affiliation: INSERM U-1148, Paris, France; Université Paris-Diderot, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, DHU FIRE, Paris, France; and NHLI, ICMS, Imperial College, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Philippe Gabriel
authors.initials: PG
authors.lastname: Steg
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome