Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF)

Kirchhof, Paulus; Ammentorp, Bettina; Darius, Harald; De Caterina, Raffaele; Le Heuzey, Jean-Yves; Schilling, Richard John; Schmitt, Josef; Zamorano, Jose Luis

doi:10.1093/europace/eut263

Cited by 404Atrial Fibrillation Management and OutcomesVenous Thromboembolism Diagnosis and ManagementAcute Ischemic Stroke Management

Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF)

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Kirchhof, Paulus, Ammentorp, Bettina, Darius, Harald, De Caterina, Raffaele, Le Heuzey, Jean-Yves, Schilling, Richard John, Schmitt, Josef, Zamorano, Jose Luis·2014·EP Europace

DOI 10.1093/europace/eut263PMC PMC3864758

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Abstract

AIMS: We sought to describe the management of patients with atrial fibrillation (AF) in Europe after the release of the 2010 AF Guidelines of the European Society of Cardiology. METHODS AND RESULTS: The PREFER in AF registry enrolled consecutive patients with AF from January 2012 to January 2013 in 461 centres in seven European countries. Seven thousand two hundred and forty-three evaluable patients were enrolled, aged 71.5 ± 11 years, 60.1% male, CHA2DS2VASc score 3.4 ± 1.8 (mean ± standard deviation). Thirty per cent patients had paroxysmal, 24.0% had persistent, 7.2% had long-standing persistent, and 38.8% had permanent AF. Oral anticoagulation was used in the majority of patients: 4799 patients (66.3%) received a vitamin K antagonist (VKA) as mono-therapy, 720 patients a combination of VKA and antiplatelet agents (9.9%), 442 patients (6.1%) a new oral anticoagulant drugs (NOAC). Antiplatelet agents alone were given to 808 patients (11.2%), no antithrombotic therapy to 474 patients (6.5%). Of 7034 evaluable patients, 5530 (78.6%) patients were adequately rate controlled (mean heart rate 60-100 bpm). Half of the patients (50.7%) received rhythm control therapy by electrical cardioversion (18.1%), pharmacological cardioversion (19.5%), antiarrhythmic drugs (amiodarone 24.1%, flecainide or propafenone 13.5%, sotalol 5.5%, dronedarone 4.0%), and catheter ablation (5.0%). CONCLUSION: The management of AF patients in 2012 has adapted to recent evidence and guideline recommendations. Oral anticoagulant therapy with VKA (majority) or NOACs is given to over 80% of eligible patients, including those at risk for bleeding. Rate is often adequately controlled, and rhythm control therapy is widely used.

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The EHRA scale has been used and validated.
“The EHRA scale has been used and validated.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [194]
Some AF patients had no or minimal symptoms (25-40%).
“While some AF patients had no or minimal symptoms (25-40%), many (15-30%) reported severe or disabling symptoms.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [194]
Many AF patients (15-30%) reported severe or disabling symptoms.
“While some AF patients had no or minimal symptoms (25-40%), many (15-30%) reported severe or disabling symptoms.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [194]
AF-related symptoms are most commonly fatigue/tiredness and exertional shortness of breath, or less frequently palpitations and chest pain.
“AF-related symptoms are most commonly fatigue/tiredness and exertional shortness of breath, or less frequently palpitations and chest pain.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [194]

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[17]Lip G EUR Observational research programme: atrial fibrillation general registry pilot phase Eur H J 2013 34 794 23614139

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Authors: Kirchhof, P., Ammentorp, B., Darius, H., De Caterina, R., Le Heuzey, J.-Y., Schilling, R. J., Schmitt, J., & Zamorano, J. L.
Affiliations: University of Münster (DE)
Daiichi Sankyo (Germany) (DE)
Vivantes Klinikum (DE)
St Thomas' Hospital (GB)
Corresponding author: Kirchhof, Paulus
ORCID: Kirchhof, Paulus
Schilling, Richard John
Venue: EP Europace
Publisher: Oxford University Press (OUP)
Published: 2013-10-01
Volume: 16
Issue: 1
Pages: 6-14
ISSN: 1099-5129 (ISSN-L)
1532-2092
DOI: 10.1093/europace/eut263
PMC: PMC3864758
OpenAlex: W1973416160
Cited by: 404
References: 24
Citations by year: 2026: 3 · 2025: 8 · 2024: 16 · 2023: 15 · 2022: 20 · 2021: 31 · 2020: 46 · 2019: 27 · 2018: 36 · 2017: 59 · 2016: 44 · 2015: 56 · 2014: 36 · 2013: 6
FWCI: 32.15
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: EP Europace (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
Funders: Daiichi Sankyo Europe
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Keywords: atrial fibrillation, clinical management, oral anticoagulation, vitamin K antagonists, direct oral anticoagulants, antiplatelet therapy, rate control, rhythm control, cardioversion, antiarrhythmic drugs, catheter ablation, guideline adherence, bleeding risk, CHA2DS2-VASc score
MeSH terms: Aged, Anticoagulants, Atrial Fibrillation, Cardiology, Europe, Female, Humans, Male, Practice Patterns, Physicians', Platelet Aggregation Inhibitors, Registries, Thromboembolism, Vitamin K, Comorbidity, Causality, Prevalence, Practice Guidelines as Topic, Guideline Adherence

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Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events—European Registry in Atrial Fibrillation (PREFER in AF)

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