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. 2009 Apr;11(4):423-34.
doi: 10.1093/europace/eun369. Epub 2009 Jan 18.

The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management

Michael Nabauer  1 , Andrea Gerth, Tobias Limbourg, Steffen Schneider, Michael Oeff, Paulus Kirchhof, Andreas Goette, Thorsten Lewalter, Ursula Ravens, Thomas Meinertz, Günter Breithardt, Gerhard Steinbeck
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The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management

Michael Nabauer et al. Europace. 2009 Apr.

Abstract

Aims: The aim of this study was to describe the characteristics of patients with atrial fibrillation (AF) enrolled in the Central Registry of the German Competence NETwork on Atrial Fibrillation (AFNET) and to assess current medical practice in patients treated at various levels of medical care in Germany.

Methods and results: From February 2004 to March 2006, 9582 ambulatory and hospitalized patients with ECG-documented AF were enrolled by 194 participating study centres from all levels of medical care in Germany. Clinical type of AF was reported as paroxysmal in 2893, persistent in 1873, and permanent in 3134 patients or classified as a first episode in 1035 patients. Predisposing conditions were common and present in 87.6% of the patients. Most patients were symptomatic with AF (75.1%). Rhythm control in persistent AF was provided to 53.4% of the symptomatic patients and to 47.8% of the patients without symptoms. Anticoagulation for stroke prevention was given to 71.4% of the patients considered eligible by applicable guidelines and to 48.4% of patients with low risk where guidelines do not recommend anticoagulation.

Conclusion: This registry provides insight into current medical care of patients with AF in Germany. The use of oral anticoagulation in eligible patients was among the highest reported, whereas decisions on rate and rhythm control often do not follow current recommendations.

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Figures

Figure 1
Figure 1
Age distribution for men and women enrolled in the central patient registry of the German AFNET. The male/female ratio was 1.6; 22.2% of men and 40.1% of women were 75 years or older.
Figure 2
Figure 2
Shift of atrial fibrillation type from paroxysmal to permanent in relation to concomitant conditions known to promote atrial fibrillation. Factors counted were age ≥75 years, hypertension, diabetes, cardiomyopathy, heart failure, valve disease or replacement.
Figure 3
Figure 3
Anti-thrombotic treatment of patients eligible and ineligible for oral anticoagulation according to the ACC/AHA/ESC Guidelines 2001, applicable during recruitment of the patients. Stroke risk factors are given in Appendix 1. Overall, 71.4% of the eligible patients received anticoagulation (oral anticoagulation or low-molecular-weight heparin for anticoagulation purposes). In patients not eligible, anticoagulation was given in 49.4%. OAC, oral anticoagulation; LMWH, low-molecular-weight heparin; antiplatelet, aspirin, clopidogrel, or ticlopidine.
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