Abstract 12992: Management of Valvular Atrial Fibrillation in Real-Life Practice: Insights from the RealiseAF Survey
Background: There is a paucity of data regarding the risk profile and real life management of valvular atrial fibrillation (AF) that is often excluded from large trials, compared to nonvalvular AF.
Purpose: The objective of this analysis was to explore the characteristics of patients with valvular AF and its management compared with the rest of the population of nonvalvular AF among patients of the RealiseAF registry.
Methods: RealiseAF is an international, cross-sectional survey of patients with AF, from 831 sites in 26 countries on 4 continents. Overall, 10,523 patients were eligible for analysis, with at least 1 AF episode documented by standard electrocardiogram (ECG) or by Holter-ECG monitoring within the previous 12 months. AF was considered of valvular origin when it was associated with significant valvular heart disease. For this analysis, assessments included the incidence of valvular disease, demography, AF history, and AF control on the day of the visit, hospitalizations in the previous year, oral anticoagulant use according to CHADS2 score, and treatment strategy prior to the visit.
Results: Valvular AF was observed in 2779 patients (26.7%). Mitral valve disease was observed in 2272 patients (21.9%), aortic valve disease in 895 patients (8.6%), and other valve lesions in 405 patients (3.9%).
Conclusion: Valvular AF was associated with higher incidences of stroke, peripheral embolism, and major bleeding. Oral anticoagulants were widely used regardless of the CHADS2 score. Permanent AF was more frequent than other types of AF, and rate control was the most frequently used strategy. Dedicated guidelines for management of patients with valvular AF could improve outcomes.
- © 2011 by American Heart Association, Inc.