Abstract
Purpose
The purpose of this study is to describe the pharmacologic management of rate and
rhythm and assess which factors are associated with the prescription of these drugs
in patients with nonvalvular atrial fibrillation (AF) from the Effectiveness, Safety,
and Costs in Atrial Fibrillation study.
Methods
This retrospective, cross-sectional study describes the pharmacologic rate and rhythm
control management strategies adopted during 2012 in all patients diagnosed as having
nonvalvular AF in 2007 to 2011. The data source is the Information System for the
Improvement of Research in Primary Care database, which is based on primary care electronic
health records. To answer the study objectives, 3 multivariate regression models to
assess the independent factors associated with the prescription of these drugs were
conducted for 2012. The rate and rhythm control drugs assessed were β-blockers, nondihydropyridine
calcium channel blockers, antiarrhythmic agents, and digoxin.
Findings
A total of 21,304 patients were diagnosed as having nonvalvular AF; 11,638 (54.6%)
had at least one heart rate measure during 2012. Of them, 7777 (66.8%) received one
or more rate and/or rhythm control drugs during 2012. Most patients (5751 [73.9%]
of 7777) received only one drug for rate and/or rhythm control. Rate control agents
were the most frequently used in 2012, with β-blockers the most prescribed group (4091
patients [52.6%]). A variety of different variables were associated with the prescription
of rate and/or rhythm control drugs in the multivariate regression models.
Implications
The most used pharmacologic treatment of rate and rhythm control in our AF population
is β-blockers, indicating that a rate control strategy is preferred in our setting,
as widely recommended.
Key words
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Article info
Publication history
Published online: February 26, 2016
Accepted:
February 1,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
