title: Clinical presentation, management, and outcomes in the Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF) registry.
abstract: OBJECTIVE
  A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes.
  
  
  METHODS
  A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed.
  
  
  RESULTS
  The average age of Indian AF patients was 54.7 years. There was a marginal female preponderance - 51.5% females and 48.5% males. At baseline, 20.4% had paroxysmal AF; 33% had persistent AF; 35.1% had permanent AF and 11% had first AF episode. At one-year follow-up, 45.6% patients had permanent AF. Rheumatic valvular heart disease (RHD) was present in 47.6% of patients. Hypertension, heart failure, coronary artery disease, and diabetes were seen in 31.4%, 18.7%, 16.2%, and 16.1%, respectively. Rate control was the strategy used in 75.2% patients, digoxin and beta-blockers being the most frequently prescribed rate-control drugs. Oral anticoagulation (OAC) drugs were used in 70% of patients. The annual mortality was 6.5%, hospitalization 8%, and incidence of stroke 1%.
  
  
  CONCLUSIONS
  In India, AF patients are younger and RHD is still the most frequent etiology. Almost two-third of the patients have persistent/permanent AF. At one-year follow-up, there is a significant mortality and morbidity in AF patients in India.
authors.affiliation: Arrhythmia Associates, Mumbai, India. Electronic address: amvora@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Vora
authors.affiliation: Department of Cardiology, Sanjay Gandhi Post-Graduate Institute, Lucknow, India.
authors.forename: A
authors.initials: A
authors.lastname: Kapoor
authors.affiliation: Holy Family Hospital, New Delhi, India.
authors.forename: M
authors.initials: M
authors.lastname: Nair
authors.affiliation: Arrhythmia Associates, Mumbai, India.
authors.forename: Y
authors.initials: Y
authors.lastname: Lokhandwala
authors.affiliation: Division of Electrophysiology, Care Hospital, Hyderabad, India.
authors.forename: C
authors.initials: C
authors.lastname: Narsimhan
authors.affiliation: Narayana Hrudyalaya Hospital, Bengaluru, India.
authors.forename: A G
authors.initials: AG
authors.lastname: Ravikishore
authors.affiliation: Department of Cardiology, King George Medical University, Lucknow, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Dwivedi
authors.affiliation: Department of Cardiology, Sri Chitra Trinumal Hospital, Trivandrum, India.
authors.forename: N
authors.initials: N
authors.lastname: Namboodiri
authors.affiliation: KIMS Hospitals, Hyderabad, India.
authors.forename: R
authors.initials: R
authors.lastname: Hygriv
authors.affiliation: Cardiac Pacing & Electrophysiology, Fortis Escorts Hospital, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Saxena
authors.affiliation: Department of Cardiology, KEM Hospital, Mumbai, India.
authors.forename: A
authors.initials: A
authors.lastname: Nabar
authors.affiliation: Maulana Azad Medical College, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Garg
authors.affiliation: Cardiology Department, Apollo Hospital, Guwahati, India.
authors.forename: N
authors.initials: N
authors.lastname: Bardoloi
authors.affiliation: Department of Cardiology, AIIMS Hospital, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Yadav
authors.affiliation: Cardiology, Baby Memorial Hospital, Kozhikode, India.
authors.forename: A
authors.initials: A
authors.lastname: Nambiar
authors.affiliation: Madras Medical Mission Hospital, Chennai, India.
authors.forename: U
authors.initials: U
authors.lastname: Pandurangi
authors.affiliation: Lilavati Hospital, Mumbai, India.
authors.forename: D
authors.initials: D
authors.lastname: Jhala
authors.affiliation: Division of Electrophysiology, CIMS Hospital, Ahmedabad, India.
authors.forename: A
authors.initials: A
authors.lastname: Naik
authors.affiliation: M.S. Ramaiah Memorial Hospital, Bengaluru, India.
authors.lastname: Nagmallesh
authors.affiliation: Department of Cardiology, Railway Hospital, Chennai, India.
authors.forename: S
authors.initials: S
authors.lastname: Rajagopal
authors.affiliation: Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: R
authors.initials: R
authors.lastname: Selvaraj
authors.affiliation: Division of Electrophysiology, Max Superspeciality Hospital, Delhi, India.
authors.forename: V
authors.initials: V
authors.lastname: Arora
authors.affiliation: Division of Electrophysiology, Lisie Hospital, Kochi, India.
authors.forename: A
authors.initials: A
authors.lastname: Thachil
authors.affiliation: Frontier Lifeline Hospital, Chennai, India.
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.affiliation: Quintiles Cardiac Safety Services, Mumbai, India.
authors.forename: G
authors.initials: G
authors.lastname: Panicker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D002309:Cardiology; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012955:Societies, Medical; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Antiarrhythmic drugs; Anticoagulation; Atrial fibrillation; Epidemiology; Rheumatic heart disease