Management of atrial fibrillation still suboptimal in Europe


Results of EORP-AF, a pilot registry on the management and treatment of atrial fibrillation in Europe, have shown that compliance with treatment guidelines for atrial fibrillation patients with the lowest and higher stroke risk scores remains suboptimal. The results also showed that oral anticoagulant use has increased, but new oral anticoagulant use is still low.

The EORP-AF (Euro observational research programme atrial fibrillation) pilot general registry results were published in Europace.

“New guidelines on the management of atrial fibrillation were recently published by the ESC and we wanted to find out how clinicians were adhering to them. Our registry was a survey of their implementation as well as the uptake of catheter ablation, new antithrombotic drugs and new anti arrhythmic agents, amongst other data,” says Gregory Lip (Birmingham, UK), chairman of the EORP-AF programme. “Drug prescription patterns showed interesting changes over the last decade. Adherence to recommendations for oral anticoagulant use has improved somewhat (in 80% overall), although they are significantly less used in females. Non-vitamin K oral anticoagulants on the contrary, were used only in 8.4%, but reflected the fact that novel oral anticoagulants were not widely available in all countries.”

For the pilot phase, nine European countries participated, with enrolment starting in February 2012 and ending in March 2013. In total, 3,119 patients with atrial fibrillation were enrolled, with full data on clinical subtype available for 3,049 patients (40.4% female; mean age 68.8 years). Common comorbidities were hypertension, coronary disease and heart failure. Lone atrial fibrillation was present in only 3.9% (122 patients). Asymptomatic atrial fibrillation was common, particularly among those with permanent atrial fibrillation.

“This registry allowed a timely assessment of the clinical scenario in Europe regarding the management of atrial fibrillation. The follow-up period of the survey will allow the evaluation of morbidity/mortality over time and also the comparison between outcomes in European regions with different patterns of practice and the dissimilar adherence to ESC guidelines,” says Aldo Maggioni (Sophia Antipolis, France), EORP scientific coordinator. “Atrial fibrillation is the commonest cardiac rhythm disorder. Recent projections estimate that the number of adults (55 years and older) with atrial fibrillation in Europe, will double between 2010 and 2060. This increase would have major public health implications, which is why having a clear picture of where we stand today regarding clinical practice among European cardiologists is so important.”

“The pilot registry allowed us to measure current disease management strategies. We look forward to a more comprehensive assessment of the management and treatment of atrial fibrillation in all ESC member countries once we have the results of the EORP-AF general long-term registry. We have high hopes to be in a position to announce results from 2015 onwards,” notes Lip.