Symptom management strategies: rhythm versus rate control in patients
with atrial fibrillation in the Balkan region: Data from the BALKAN-AF
Survey
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.