An International Observational Prospective Survey Assessing the Control of Atrial Fibrillation in Asia-Pacific: Results of the Record-AFAP Registry

Abstract

A prospective 1-year observational survey was designed to assess the management and control of atrial fibrillation (AF) in eight countries within the Asia-Pacific region. Patients (N = 2,604) with recently diagnosed AF or a history of AF ≤1 year were included. Clinicians chose the treatment strategy (rhythm or rate control) according to their standard practice and medical discretion. The primary endpoint was therapeutic success. At baseline, rhythm- and rate-control strategies were applied to 35.7% and 64.3% of patients, respectively. At 12 months, therapeutic success was 43.2% overall. Being assigned to rhythm-control strategy at baseline was associated with a higher therapeutic success (46.5% vs 41.4%; P = 0.0214) and a lower incidence of clinical outcomes (10.4% vs 17.1% P < 0.0001). Patients assigned to rate-control strategies at baseline had higher cardiovascular morbidities (history of heart failure or valvular heart disease). Cardiovascular outcomes may be less dependent on the choice of treatment strategy than cardiovascular comorbidities.

Factors influencing warfarin control in Australia and Singapore

“…(26) Consistent with this, in both Australia and Singapore, our study included a higher percentage of males and hypertension was the most common co-morbidity. The most common concurrent treatment at both sites was with betablockers which is also consistent with Amerena et al (14) who concluded that clinicians in the Asia-Pacific region prefer rate-control strategies. However there were several differences between the two populations.…”

“…Amerena et al (14) found significant regional differences in treatment strategies and clinical cardiovascular outcomes in AF patients across Asia-Pacific countries. Chen et al (15) reported more than 70% of physicians in Australia and Singapore prescribe oral anticoagulants for stroke prevention but found suboptimal warfarin control to be a larger problem in Asia than other regions.…”