Intraprocedural anticoagulation in patients on non-vitamin K antagonist oral anticoagulants undergoing catheter ablation for atrial fibrillation

Atrial fibrillation(AF)catheter ablation,usually performed in patients on oral anticoagulation—either traditional vitamin K antagonists(VKAs)or non-vitamin K antagonist oral anticoagulants(NOACs)-entails contrasting risks:on the one hand,a risk of major bleeding,including hemopericardium,and on the other hand,a high transient procedure-related risk of thromboembolism that necessitates particularly rigorous anticoagulation throughout the procedure.

Anticoagulation for atrial fibrillation in heart failure patients:balancing between Scylla and Charybdis

The management of heart failure(HF)and atrial fibrillation(AF)in realworld practice remains a debating issue,while the number of HF patients with AF increase dramatically.While it is unclear if rhythm or rate control therapy is more beneficial and under which circumstances,anticoagulation therapy is the cornerstone of the AFHF patients’approach.VitaminK antagonists were the goldstandard during the past,but currently their usage is limited in specific conditions.Nonvitamin K oral anticoagulants(NOACs)have gained ground during the last ten years and considered as goldstandard of a wide spectrum of HF phenotypes.The current manuscript aims to review the current literature regarding the indications and the optimal choice and usage of NOACs in HF patients with AF.

Understanding the effect of propofol and electrical cardioversion on the systolic blood pressure of emergency department patients with atrial fibrillation

Dear editor, We read with pleasure the well-designed study by Butler et al of electrical cardioversion of emergency department patients with atrial fibrillation. We appreciate their analysis of the distinctives of procedural sedation when employed for this indication. Understanding the dosing adjustments to propofol undertaken by their sedationists will help us more carefully evaluate our own approach to sedating patients undergoing electrical cardioversion of atrial fibrillation.

Beta-blockers and 1-year clinical outcomes in hospitalized heart failure patients with atrial fibrillation

OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ejection fraction(LVEF)level.METHODS We enrolled hospitalized HF patients with AF from China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study.COX proportional hazard regression models were employed to calculate hazard ratio of betablockers.The primary outcome was all-cause death.RESULTS Among 1762 HF patients with AF(756 women[41.4%]),1041(56%)received beta-blockers at discharge and 1272(72.2%)had an LVEF>40%.During one year follow up,all-cause death occurred in 305(17.3%),cardiovascular death occurred in203 patients(11.5%),and rehospitalizations for HF occurred in 622 patients(35.2%).After adjusting for demographic characteristics,social economic status,smoking status,medical history,anthropometric characteristics,and medications used at discharge,the use of beta-blockers at discharge was not associated with all-cause death[hazard ratio(HR):0.86;95%Confidence Interval(CI):0.65-1.12;P=0.256],cardiovascular death(HR:0.76,95%CI:0.52-1.11;P=0.160),or the composite outcome of all-cause death and HF rehospitalization(HR:0.97,95%CI:0.82-1.14;P=0.687)in the entire cohort.There were no significant interactions between use of beta-blockers at discharge and LVEF with respect to all-cause death,cardiovascular death,or composite outcome.In the adjusted models,the use of beta-blockers at discharge was not associated with all-cause death,cardiovascular death,or composite outcome across the different levels of LVEF:reduced(<40%),mid-range(40%-49%),or preserved LVEF(≥50%).CONCLUSION Among HF patients with AF,the use of beta-blockers at discharge was not associated with 1-year clinical outcomes,regardless of LVEF.

Opportunistic screening for atrial fibrillation with a single lead device in geriatric patients

Objective To determine the diagnostic yield of repeated screening for atrial fibrillation(AF)among geriatric patients.Methods A pragmatic prospective cohort study into applying opportunistic screening for AF with a handheld single lead ECG device(SLD)in a geriatric cohort.Consecutive patients of 65 years old and older visiting the geriatric outpatient clinic were eligible for inclusion.A 12 lead ECG was performed,followed by measurements with the SLD during every visit to the geriatric outpatient clinic.A frailty index was based on the accumulation of deficits model.Results 478 patients were eligible.Patients were excluded if they did not give informed consent(17 patients),had a pacemaker or implantable cardioverter defibrillator(20 patients),or had incomplete medical files(two patients).After exclusion,439 patients participated in this study.The mean age was 78 years(range 65 to 100 years),54%were female.AF was known in 89 patients(20%),first detected on the baseline ECG in four patients(1%)and first detected with the SLD in 20 patients(5%)during follow up visits.Sensitivity of the SLD was 90.0%,specificity 99.0%,negative predictive value 99.7%,and positive predictive value 73.5%.Most patients(82%)with AF were frail and 53%were severely frail.Conclusion Repeated screening in geriatric patients has a five times higher diagnostic yield than usual care.It was easily combined with usual care.Because of the positive predictive value of 73.5%,it remains necessary to confirm AF with a 12 lead ECG or 24-h Holter monitoring.

Periprocedural complications and one-year outcomes after catheter ablation for treatment of atrial fibrillation in elderly patients:a nationwide Danish cohort study

OBJECTIVES To investigate complications within 30-days following first-time ablation for atrial fibrillation(AF),including a composite of cardiac tamponade,hematoma requiring intervention,stroke or death,in patients≥75 years of age,compared to pa-tients aged 65−74 years.In addition,one-year all-cause mortality and AF relapse were compared.METHODS&RESULTS All patients receiving their first catheter ablation for AF between 2012 and 2016 were identified us-ing Danish nationwide registries.Patients aged 65−74 years served as the reference group for patients≥75 years.Relapse of AF within one year was defined as cardioversion following a three-month blanking period,re-ablation or confirmed relapse within follow-up.The composite complication outcome did not differ between the two age groups,with 39/1554(2.8%)in patients 65−74 years of age,versus 5/199(2.5%)in older patients(adjusted HR=0.94),95%CI:0.37−2.39,P=0.896).Patients≥75 years or older had no increased hazard of death within 30 days after the procedure,with an incidence of 3/1554(0.2%)in younger pa-tients and 2/199(1.0%)in patients≥75 years of age(adjusted HR=4.71,95%CI:0.78−28.40,P=0.091).There was no difference in relapse of AF after one year between age groups(≥75 years adjusted HR=1.00,95%CI:0.78-1.26,P=0.969).CONCLUSION In patients≥75 years of age selected for catheter ablation for AF,the incidence of periprocedural complica-tions,as well as one-year freedom from AF showed no statistical difference,when compared to patients 65−74 years of age.

Safety of digoxin in nonagenarian patients with atrial fibrillation:lessons from the Spanish Multicenter Registry

BACKGROUND The association between digoxin and mortality is an unclear issue.In older patients with atrial fibrillation(AF),where use of digoxin is frequent,the evidence of its safety is scarce.Our aim is to assess the safety of digoxin in nonagenarian patients with AF.METHODS We evaluated data from 795 nonagenarian patients with non-valvular AF from the Spanish Multicenter Registry.We analyzed the relationship between digoxin and all-cause mortality with the Cox proportional-hazards model.RESULTS Follow-up was 27.7±18.3 months.Mean age was 92.5±3.8 years,and 71%of nonagenarian patients were female.Digoxin was not associated with increased risk of mortality[adjusted hazard ratio(aHR)=1.16,95%CI:0.96−1.41,P=0.130].However,we found a significant increase in mortality in the subgroup with estimated glomerular filtration rate(eGFR)<30 mL/min per 1.73 m^(2)(aHR=2.01,95%CI:1.13−3.57,P=0.018),but not in the other subgroups of eGFR(30−59 mL/min per 1.73 m^(2) and≥60 mL/min per 1.73 m^(2)).When exploring the risk of mortality according to sex,male subgroup was associated with an in-crease in mortality(aHR=1.48,95%CI:1.02−2.14,P=0.041).This was not observed in females subgroup(aHR=1.03,95%CI:0.81−1.29,P=0.829).Based on the presence or absence of heart failure,we did not find significant differences(aHR=1.20,95%CI:0.87−1.65,P=0.268 vs.aHR=1.15,95%CI:0.90−1.47,P=0.273,respectively).CONCLUSIONS In our large registry of nonagenarian patients with AF,we did not find an association between digoxin and mortality in the total sample.However,in the subgroup analyses,we found an increase in mortality with the use of digoxin in men and in patients with an eGFR<30 mL/min per 1.73 m^(2).

Three-year outcomes of patients with non-valvular atrial fibrillation: the COOL-AF registry

BACKGROUND Clinical outcomes of patients with non-valvular atrial fibrillation(AF)in Asian populations may be different from non-Asians.In this study,we aimed to determine the incidence of ischemic stroke/systemic embolism(SSE),major bleeding,and death,and the predictors for clinical outcomes in a contemporary Asian cohort of newly diagnosed AF patients.METHODS This is a prospective multicenter nationwide registry of patients with AF from 27 hospitals in Thailand.Baseline data and follow-up data were collected every 6 months until 3 years.Data collections included demographic,medical history,laboratory,and medication details.Clinical outcomes were SSE,major bleeding,and all-cause mortality.Incidence rates for each clinical outcome were calculated and presented as rate per 100 person-years.Univariate and multivariate analysis was performed to determine the independent predictors for clinical outcomes.RESULTS There was a total of 3405 patients:mean age was 67.8±11.3 years,1981(58.2%)were male.During 30.8±9.7 months follow-up,there was a total of 132 SSE(3.9%),191 major bleeding(5.6%),and 357 all-cause deaths(10.5%).The incidence rates of SSE,major bleeding,and death were 1.56(1.30-1.84),2.26(1.96-2.61),and 4.17(3.33-4.25),per 100 person-years respectively.Independent predictors for clinical outcomes were age,type of AF,and the presence of comorbid conditions.CONCLUSION The incidence rate of SSE,major bleeding,and death remains high reflecting the unmet needs in AF management。

Predictive value of bleeding risk scores in elderly patients with atrial fibrillation and oral anticoagulation

BACKGROUND The predictive value of bleeding risk scores for atrial fibrillation in older patients is not as well known.The goal of this study was to evaluate the predictive value of HASBLED,ORBIT and ATRIA for major bleeding(MB)and intracranial hemorrhage(ICH)in patients≥75 years with atrial fibrillation and oral anticoagulation(OAC).METHODS A retrospective unicenter study including patients≥75 years with atrial fibrillation(AF)and OAC.A total of 7613 patients≥75 years with AF and OAC included between 2014 and 2018(registry:NCT04364516).We analyzed the discriminative value of HASBLED,ATRIA and ORBIT scores for bleeding endpoints(major bleeding as primary endpoint and intracerebral hemorrhage as secondary).Cox regression was used to predict major bleeding with each scale and also for searching other variables potentially predictor of major bleeding.Model discrimination was assessed using Harrell’s C-statistic.Calibration was assessed with goodness-of-fit test proposed by Gronnesby and Borgan.RESULTS During a mean follow up of 4.0 years(IQR:2.4–5.7 years),729 patients developed MB(2.61 per 100 patients/year)and 243 patients developed ICH(0.85 per 100 patients/year).Three scores showed a low discrimination for major bleeding,being ORBIT the best(HASBLED C statistic=0.557;ATRIA C statistic=0.568;ORBIT C statistic=0.595)and also a low discrimination for ICH(HASBLED C statistic=0.509;ATRIA C statistic=0.522;ORBIT C statistic=0.526).Among the variables that are part of the scores and other baseline characteristics,after multivariable adjustment only sex(male),dementia,prior admission for bleeding,anemia and liver disease were found as a predictors of MB.CONCLUSIONS In older patients under oral anticoagulation with atrial fibrillation,the risk scores HASBLED,ATRIA and ORBIT showed a weak discrimination for major bleeding and intracranial hemorrhage.Therefore,other better alternatives should be evaluated for this purpose.

Hyperuricemia predicted adverse outcomes in very elderly patients with non-valvular atrial fibrillation

Objective Elevated serum uric acid predicts poor outcomes in patients with cardiovascular disease.We aimed to examine associations between hyperuricemia and clinical outcomes among very elderly patients with non-valvular atrial fibrillation(NVAF).Methods Elderly patients(≥80 years)with NVAF admitted to our hospital from January 2009 to December 2015 were retrospectively studied and were followed up until April 2017.

Persistent ductus arteriosus in old patient with atrial fibrillation

Persistent ductus arteriosus （PDA） is a congenital cardiovascular malformation connecting the pulmonary trunk of the proximal left pulmonary artery and the descending aorta distal to the left subclavian artery. Normally, the duct closes after birth as a result of a sudden increase in arterial oxygen saturation and a decrease in the level of vasoaetive prostaglandins. The incidence of persistent ductus arteriosus accounts for approximately 10% of all congenital heart diseases.

Pulse Pressure as a Risk Factor of Atrial Fibrillation in Black African Elderly Patients

Objective: The aim of this study was to show the prognostic role of High Pulse Pressure (PP) in the occurrence of atrial fibrillation in Black African elderly patients. Materials and Methods: In a comparative retrospective study related to 2000 patients admitted to the Institute of Cardiology of Abidjan, from January 1991 to December 2010 for atrial fibrillation, we matched pulse pressure and atrial fibrillation in Black African elderly patients. Results: The mean age of patients was 65 ± 10 years. Patients with high pulse pressure were 4.8 times more at risk to present atrial fibrillation than those with normal pulse pressure. The threshold of high risk pulse pressure was 65 mmHg. Conclusion: Pulse pressure is a factor of bad prognosis of atrial fibrillation in Black African elderly patients.

Detecting the nerve function of fibril in patients with cervicalspondylotic radiculopathy using quantitative sensory testing

BACKGROUND: Pain and sensory disability are greatly affected by subjective factors, there are no quantitative indexes to evaluate cervical spondylotic radiculopathy(CSR). The judgment on clinical body examination and chief complaint always causes nonobjective results with great individual differences. Quantitative sensory testing (QST) can be used to judge the nerve function of fibril. The application of QST for the quantitative evaluation of peripheral nervous system disease needs to be further studied. OBJECTIVE: The cold-thermal sensation and pain of patients with CSR are quantitatively analyzed by using QST technology in order to evaluate the nerve function of fibril in patients with CSR. DESIGN: Case-control observation. SETTING: Pain Center of Beijing Hospital of Ministry of Health. PARTICIPANTS: Twenty patients with CSR, including 8 males and 12 females, aged from 33 to 70 years, who received treatment between January and April 2005 in Pain Center of Beijing Hospital of Ministry of Health were involved in CSR group. All the involved patients presented symptoms in unilateral upper extremity (left side 10 patients, right side 10 patients). They did not undergo physical therapy or nerve block therapy in 1 week before examination. Eight non-CSR patients who received treatment in Pain Center concurrently were involved in the control group (2 patients with trigeminal neuralgia, 4 with osteoarthrosis of knee joint and 2 with lumbar intervertebral disc protrusion), and another 12 healthy volunteers were involved. Four non-CSR patients and 12 healthy volunteers, 8 male and 12 female, were aged from 23 to 75 years. The informed consents were obtained from all the involved subjects. METHODS: The volar thresholds of cold sensation, thermal sensation, cryalgesia of thenar eminence of both upper extremities of all the subjects were examined separately by limit method with type TSA-Ⅱ temperature sensation analysator made by Medco Company (Israel). The subjects were pre-examined to be familiar with the method for sensory discrimination and affirmation. Thenar eminence vola of bilateral upper extremities were detected. The infrared detector of a semiconductor was contacted with skin. The infrared detector could be used to heat and cool skin. A group of cold-heat water circulation device was given electric current to produce temperature gradient, which was higher or lower than skin temperature. The initial temperature of infrared detector was 32 ℃, stimulation temperature was increased or decreased progressively at 1 ℃/s, and temperature change range was 0 to 50 ℃. In the first step, subjects pressed down the button to stop the stimulation when the temperature of infrared detector was decreased progressively until the subjects felt, and the threshold of cold sensation was obtained; In the second step, the threshold of thermal sensation was obtained when the temperature of infrared detector was increased progressively until the subjects felt; In the third step, the threshold of cryalgesia was obtained when the temperature of infrared detector was decreased progressively until subjects felt; and in the fourth step, the threshold of thermalgesia was obtained when the temperature of infrared detector was increased progressively until subjects felt. Each step was conducted 4 times and the mean threshold was obtained. Before each measurement, the temperature was made to rebound to the initial temperature and kept for 10 s. MAIN OUTCOME MEASURES: The thresholds of cold sensation, thermal sensation and cryalgesia, thermalgesia of thenar eminence vola of bilateral upper extremities of all the subjects. RESULTS: Twenty patients with CSR and 20 healthy subjects participated in the final results. ① In the CSR group, the threshold of cold sensation of affected side was lower than that of intact side [(29.00±1.26) ℃ vs.(30.00±1.06) ℃, P < 0.05], and the threshold of thermal sensation of affected side was higher than that of intact side [(35.04±0.87) ℃ vs. (34.14±0.99) ℃, P < 0.05]. There were no significant differences in the thresholds of cold and thermal sensation between affected side and intact side (P > 0.05). ②In the CSR group, the difference of threshold of cold sensation, thermal sensation, cryalgesia and thermalgesia between affected side and intact side was (-1.01±0.57), (0.89±0.39), (2.49±1.10) and (-1.62±0.86) ℃, respectively , the absolute value of which was higher than that of control group, respectively [(0.04±0.28),(0.05±0.26),(0.28±1.79),(0.17±1.10) ℃,P < 0.01]. In the CSR group, the threshold of cold sensation and thermalgesia of affected side was lower than that of intact side, respectively; and the threshold of thermal sensation and cryalgesia of affected side was higher than that of intact side, respectively. CONCLUSION: The superficial sensation of affected extremity of patients with CSR is lessened as compared with that of intact extremity. There are dysfunctions of small myelinated fiber (Aδ fiber) and demyelinated fiber (C fiber) in the affected-side extremity. QST, as a mean for quantitatively evaluating the function of Aδ fiber and C fiber, plays an objective evaluative role in the diagnosis and therapeutic effect observation of CSR.

Ablation of drivers in patients with persistent atrial fibrillation refractory to pulmonary vein antral isolation:Target characteristics and 3-year outcomes

To the Editor:Pulmonary vein antral isolation(PVAI)is the cornerstone of catheter ablation techniques used in the treatment of patients with atrial fibrillation(AF).However,the outcomes of a PVAI-only strategy for persistent AF have proven suboptimal.The majority of patients with persistent AF may require further atrial ablation beyond PVAI.Ablation of AF drivers,a patient-tailored ablation strategy for persistent AF with a procedural endpoint of AF termination,has garnered increasing attention in recent years.[1]We aimed to determine the electrogram(EGM)characteristics of AF drivers that can predict AF termination.

Neutrophil-to-lymphocyte ratio compared to N-terminal pro-brain natriuretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure

Background The neutrophil-to-lymphocyte （N/L） ratio has been associated with poor prognosis in patients with heart failure, but it has not been compared with N-terminal pro-brain natriuretic peptide （NT-proBNP） in elderly patients with chronic heart failure （CHF）. We sought to make this comparison. Methods A total of 1355 elderly patients with CHF were analyzed. A multivariate logistic regression model was used to analyze the variables associated with atrial fibrillation （AF）. Cox regression analysis was used to assess the multivariable rela- tionship between the N/L ratio, NT-proBNP level, and subsequent major cardiovascular events （MCE）. Results In the multiple logistic regression analysis, the N/L ratio was demonstrated as a risk factor for AF in elderly patients with CHF [odds ratio （OR）： 1.079, 95% confi- dence interval （CI）： 1.027-1.134, P = 0.003]. The median follow-up period was 18 months. In a multivariable model using tertiles of both variables, the highest tertile of the N/L ratio was significantly associated with MCE [hazard ratio （HR）： 1.407, 95% CI： 1.098-1.802, P = 0.007] compared with the lowest tertile. Similarly, the highest NT-proBNP tertile was also significantly associated with MCE （HR： 1.461, 95% CI： 1.104-1.934, P- 0.008）. Conclusions In elderly patients with CHF, the N/L ratio is one of the important risk factors for AF and it is an inexpensive and readily available marker with similar independent prognostic power to NT-proBNP. The risk of MCE increases 1.407-fold when the N/L ratio is elevated to the highest tertile.

Atrial fibrillation associated with tiotropium in patients with pre-existing arrhythmia: a case report

Inhaled anticholinergic agent tiotropium is widely used in the treatment of chronic obstructive pulmonary disease（COPD）. However, it has pro-arrhythmic and pro-ischaemic effects, which can potentially increase the risk of serious cardiovascular events, especially in patients with pre-existing arrhythmias. We presented a 79-year-old man with a medical history of arrhythmia, who developed atrial fibrillation after used tiotropium 18 μg daily for two weeks. We urge the caution of pro-arrhythmic effect of tiotropium. Healthcare professionals should be aware of the potential effect when prescribing tiotropium to patients with known cardiac rhythm disorders.

心房颤动导管消融围手术期患者体验测量工具的初步构建

目的初步构建心房颤动(atrial fibrillation,AF)导管消融围手术期患者体验测量工具,为改善患者围手术期体验提供可量化的依据。方法于2022年6月至2023年4月采用文献分析、质性研究、德尔菲专家咨询及层次分析法,确定房颤导管消融围手术期患者体验测量问卷的内容及各测量内容的权重。结果3轮专家的积极性均为100%,专家的权威系数分别为0.946、0.961、0.976,第2、3轮专家咨询的肯德尔协调系数为0.130、0.370(P<0.001)。初步构建的AF导管消融围手术期患者体验测量工具包含操作及技术质量体验、舒适度管理体验、信息与沟通交流体验、情感支持体验、服务流程与响应体验5个维度,共46个测量条目。结论根据专科特点初步构建的AF导管消融围手术期患者体验测量工具,不仅可以精准化评估患者体验现状,而且可以为有针对性地开展相关改进医疗机构服务质量提供依据。

不同剂量艾多沙班对非瓣膜性老年房颤患者肝肾功能的影响

目的:探究不同剂量艾多沙班对非瓣膜性老年房颤患者肝肾功能的影响。方法:选取我院2022年1月到2023年6月的118例非瓣膜性老年房颤患者,按照随机数字法分为A组(n=59)、B组(n=59),其中A组患者给与大剂量(60 mg/d)艾多沙班进行治疗,B组患者给与小剂量(30 mg/d)艾多沙班进行治疗,再按SHARE-FI评分将A组患者分为强健A组(n=30)、衰弱前期A组(n=11)、衰弱A组(n=18);将B组分为强健B组(n=31)、衰弱前期B组(n=12)、衰弱B组(n=16)。评估强健A组与强健B组,衰弱前期A组与衰弱前期B组,衰弱A组与衰弱B组肝肾功能变化。结果:治疗前后强健A组与强健B组ALT、BUN、Scr均无明显差异(P>0.05);治疗前衰弱前期A组与B组ALT、BUN、Scr无明显差异(P>0.05),治疗后衰弱前期A组ALT、BUN、Scr明显高于衰弱前期B组(P<0.05);治疗前衰弱A组与B组ALT、BUN、Scr无明显差异(P>0.05),治疗后衰弱A组ALT、BUN、Scr明显高于衰弱前期B组(P<0.05)。结论:大剂量(60 mg/d)、小剂量(30 mg/d)艾多沙班对身体强健的非瓣膜性老年房颤患者肝肾功能的影响相当;而大剂量艾多沙班对衰弱前期、衰弱期患者肝肾功能的影响较小剂量艾多沙班大,因而可给予衰弱前期、衰弱期患者小剂量艾多沙班来减少对其肝肾功能的损伤。

房颤患者参与健康照护的意愿、现状及影响因素

目的:探讨房颤患者参与健康照护的意愿、现状及影响因素。方法:选择2017年4月~2019年3月华中科技大学同济医学院附属协和医院收治的220例房颤患者,根据是否愿意接受健康照护分为研究组(愿意接受,153例)和对照组(不愿意接受,67例),收集所有患者一般资料,对患者参与健康照护的意愿和现状进行分析,并采用单因素和多因素Logistic回归分析房颤患者接受健康照护的影响因素。结果:与对照组比较,研究组患者健康照护需求评分、合并慢性病比例、自理能力差(需依赖他人)比例均显著增加,月收入<3000元比例显著减少(P均<0.01)。多因素Logistic回归分析发现,自理能力差(需依赖他人)及合并慢性疾病对房颤患者参与健康照护有正向影响(OR=2.431、2.558,P均<0.05),月收入<3000元对房颤患者参与健康照护有负向影响(OR=0.246,P=0.033)。结论:房颤患者参与健康照护的意愿较高,对健康照护的需求多样化,需结合本地区情况实施多方位和多途径的健康照护,以便提高房颤患者预后生活质量。

Contemporary characteristics,management,and outcomes of patients hospitalized for atrial fibrillation in China:results from the real-world study of Chinese atrial fibrillation registry

Atrial fibrillation(AF)is a growing public health problem in the context of the epidemiologic transition from communicable to non-communicable diseases,and a high prevalence of AF was found in Chinese patients who died in hospital.[1]Indeed,most understanding of AF is based on findings from clinical trials and observational studies performed in North America and Western Europe,[2]and some studies have described the characteristics of patients with AF in other regions.These data have highlighted the important differences in the clinical characteristics and treatment of patients with AF in these regions.[3,4]However,few studies have investigated the characteristics of patients with AF in China.Hence,the aim of this study was to investigate the clinical demographics,management,and outcomes of patients hospitalized for AF using data from a recently registered AF-specific nationwide cohort study in China,the real-world study of Chinese atrial fibrillation(RWS-CAF)registry.The RWS-CAF registry(registration number:ChiCTR1900021250)comprises a multicenter,observational,prospective cohort that includes consecutive patients requiring hospitalization with a diagnosis of AF made according to the Chinese AF guidelines,spanning from November 1,2017,to October 31,2018.All of the enrolled hospitals are grade A class three hospitals.Individual patients hospitalized with AF who were aged 18 years or older were recruited.