The Chinese emergency atrial fibrillation registry study: baseline characteristic and management

Objective The aim of this study was to investigate the baseline characteristics and management strategies for Chinese patients with atrial fibrillation/flutter (AF/AFL) presenting in emergency department (ED) . Methods We conducted a prospective, multicenter, observational registry study in patients with AF oratrial flutter (AFL) in China. AF/AFL patients who were admitted to the emergency departments of 20 hospitals nationwide from November 2008 to October 2011 were enrolled and the baseline data and treatment status were collected and analyzed. Results A total of 2015 patients with AF/AFL were enrolled.Among them, 1104 (55%) were female, and the average age was (68.5±13.3) years. The proportion of paroxysmal, persistent, and permanent AF was 31%, 22% and 47%, respectively. There were 336 cases of valvular AF/AFL (VAF) . Hypertension (56%) was the most common comorbidity, and 42% of patients were concomitant with coronary artery disease (CAD, 42%) , while 37% with heart failure (HF, 37%) .More patients used beta blocker (50.4%) , digoxin (36%) and verapamil/diltiazem (7%) to control ventricular rate, while minority of patients used amiodarone (12%) and propafenone (4%) . The prevalence of comorbidities and treatment were different between patients with different types of AF/AFL and between those with, valvular AF (VAF) and non-valvular AF (NVAF) . Among the patients with NVAF, 113 (13%) of those with CHADS2 (congestive HF, hypertension, age of 75 years and greater, diabetes mellitus and history of stroke) ≥2 were prescribed warfarin.Among patients with VAF, 141 (42%) actually were treated with warfarin. The proportion of patients undergoing anticoagulation therapy with warfarin and international normalised ratio (INR) value with in the target. Conclusions This contemporary observational registry study shows that the risk profile and management of Chinese patients with AF/AFL differed from that observed in previous studies.The anticoagulant therapy is still underused in Chinese AF/AFL patients. Key words: Atrial fibrillation; Comorbidities; Risk factors; Drug therapy; Anticoagulant therapy