Atrial fibrillation in ambulatory consultant cardiology clinics

Information on the prevalence and real-life management of atrial fibrillation (AF) in a general practice setting is sparse.

To investigate the prevalence, clinical features and real-life management of AF in ambulatory consultant cardiology clinics.

We studied consecutive new patients with a diagnosis of AF. Recorded data included demographics, comorbidities and prescribed drugs. Antithrombotic therapy was chosen according to CHADS2 score in non-rheumatic valve AF patients; for AF patients with rheumatic valve disease warfarin treatment was prescribed. The data were compared with data of patients without AF admitted to the ambulatory cardiology clinics during the same period.

The study included 865 patients whose mean age was 64.9 +/- 7.1 years. AF was reported in 137 patients (15.8%); 81 were women (59%) and the mean age was 74.4 +/- 7.5 years. Heart rate rhythm-control strategy was applied in 41 patients (45%) and rate control in 50 patients (55%) with paroxysmal or persistent AF. Rate-control strategy was used in all patients with permanent AF. In most patients AF was associated with one or more concomitant comorbidities, most frequently hypertension. Warfarin was prescribed in 98 patients with AF (71.5%), aspirin in 57 patients with AF (41.6%), and both drugs in 18 patients with AF. Amiodarone was used in 24 patients with AF (17.5%); beta blockers were used in 95 patients with AF (69.3%) and 377 patients without AF (51.8%).

We provide a snapshot of real-life contemporary daily clinical practice and evaluate AF burden and therapy. Most patients were found to have AF associated with one or more concomitant comorbidity.