title: [Current status of antiarrhythmic drug use and safety assessment in Chinese patients with atrial fibrillation].
abstract: Objective:To investigate the current status of antiarrhythmic drugs (AADs) use in Chinese patients with atrial fibrillation(AF) and assess the safety of AADs in this patient cohort.Methods:From January 2011 to December 2013, a total of 4 008 AF patients treated with AADs was enrolled in this study and patients were followed up for 24 months. Detailed information of prescribed drug, the causes of drug discontinuation and side effects were recorded.Results:Amiodarone was prescribed to 64.3%(2 579 cases) and propafenone to 31.1%(1 247 cases) of the enrolled patients, only 148 patients(3.7%) were treated with sotalol and 34 patients (0.8%) were treated with moracizine. The prevalence of heart failure (4.0%(102/2 579) vs. 1.4%(17/1 247,P<0.001), coronary heart disease (13.5% (348/2 579) vs. 7.4%(93/1 247),P<0.001) and non-ischemic cardiomyopathy (3.1%(78/2 579) vs. 0.7%(9/1 247),P<0.001) was significantly higher in patients treated with amiodarone than in the patients treated with propafenone. During the follow-up period, the discontinuation rate of amiodarone, propafenone, sotalol and moracizine was 28.8%(743/2 579), 25.1%(313/1 247), 14.2%(21/148) and 32.4%(11/34) respectively. The reasons of discontinuing amiodarone were: follow physicians' decision (75.7%, 563 cases), no effect (3.0%, 22 cases), side effects (4.3%, 32 cases) and patients' own decision (17.0%, 126 cases). The side effects of amiodarone included thyroid dysfunction (56.3%, 18 cases), bradycardia (12.5%, 4 cases), interstitial pneumonitis/pulmonary interstitial fibrosis (6.2%, 2 cases) and others (gastrointestinal symptom, rash, hepatic dysfunction, etc.).Conclusions:Amiodarone and propafenone are the most common AADs used in Chinese patients with atrial fibrillation. The prescription of AADs is essentially in accordance to the guideline of AF treatment. However, the discontinuation rates of AADs are high in Chinese AF patients. Lacking of better AADs is still a major problem in AF pharmacotherapy. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-OCH-13003729.
authors.affiliation: *Department of Cardiology, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides of Ministry of Health, Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Beijing 100191, China.
authors.forename: R
authors.initials: R
authors.lastname: He
authors.forename: X
authors.initials: X
authors.lastname: Du
authors.forename: S W
authors.initials: SW
authors.lastname: Liu
authors.forename: L J
authors.initials: LJ
authors.lastname: Sun
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: H
authors.initials: H
authors.lastname: Zeng
authors.forename: Y Y
authors.initials: YY
authors.lastname: Li
authors.forename: C
authors.initials: C
authors.lastname: Sun
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: C S
authors.initials: CS
authors.lastname: Ma
authors.forename: W
authors.initials: W
authors.lastname: Gao
mesh_terms: D000638:Amiodarone; D000889:Anti-Arrhythmia Agents; D001281:Atrial Fibrillation; D006801:Humans; D011405:Propafenone; D012042:Registries; D012449:Safety; D013015:Sotalol
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D013015:Sotalol; D000638:Amiodarone