Abstract
Background Symptom-focused management is one of the
cornerstones of optimal atrial fibrillation (AF) therapy.
Objectives To evaluate the use of rhythm control and rate
control strategy. Second, to identify predictors of the use of
amiodarone in patients with rhythm control and of the use of rhythm
control strategy in patients with paroxysmal AF in the Balkans.
Methods Prospective enrolment of consecutive patients from 7
Balkan countries to the BALKAN-AF survey was performed.
Results Of 2,712 enrolled patients, 2,522 (93.0%) with
complete data were included: 1,622 (64.3%) patients were assigned to
rate control strategy and 900 (35.7%) to rhythm control. Patients with
rhythm control were younger, more often hospitalized for AF and with
less comorbidities (all p <0.05) than those with rate control.
Symptom score [European Heart Rhythm Association (EHRA)] was not an
independent predictor of a rhythm control strategy [odds ratio (OR)
0.99, 95% confidence interval (CI) 0.90-1.10, p = 0.945]. The most
commonly chosen antiarrhythmic agents were amiodarone (49.7%), followed
by propafenone (24.3%).
Conclusion More than one third of patients in BALKAN-AF survey
received a rhythm control strategy, and these patients tended to be
younger with less comorbidities than those managed with rate control.
EHRA symptom score is not significantly associated with rhythm control
strategy. The most commonly used antiarrhythmic agents were amiodarone,
followed by propafenone.
Keywords: amiodarone, atrial fibrillation, oral anticoagulants,
rate control, rhythm control