Characteristics and Treatment of Atrial Fibrillation with Respect to the Presence or Absence of Heart Failure. Insights from the Multicenter Polish Atrial Fibrillation (POL-AF) Registry

• Published in: Journal of clinical medicine Vol. 10; no. 7; p. 1341
• Main Authors: Gawałko, Monika, Budnik, Monika, Gorczyca, Iwona, Jelonek, Olga, Uziębło-Życzkowska, Beata, Maciorowska, Małgorzata, Wójcik, Maciej, Błaszczyk, Robert, Tokarek, Tomasz, Rajtar-Salwa, Renata, Bil, Jacek, Wojewódzki, Michał, Szpotowicz, Anna, Krzciuk, Małgorzata, Bednarski, Janusz, Bakuła-Ostalska, Elwira, Tomaszuk-Kazberuk, Anna, Szyszkowska, Anna, Wełnicki, Marcin, Mamcarz, Artur, Kapłon-Cieślicka, Agnieszka
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.03.2021; MDPI
• Subjects: Ablation; anticoagulation; atrial fibrillation; Cardiac arrhythmia; Cardiology; Cardioversion; Clinical medicine; Diabetes; Disease; Heart failure; Hospitalization; Hospitals; Hypertension; Laboratories; Nonsteroidal anti-inflammatory drugs; Pathophysiology; Patients; Sinuses; Statistical analysis; Thromboembolism; heart failure; atrial fibrillation; anticoagulation
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10071341

We aimed to assess characteristics and treatment of AF patients with and without heart failure (HF). The prospective, observational Polish Atrial Fibrillation (POL-AF) Registry included consecutive patients with AF hospitalized in 10 Polish cardiology centers in 2019-2020. Among 3999 AF patients, 2822 (71%) had HF (AF/HF group). Half of AF/HF patients had preserved ejection fraction (HFpEF). Compared to patients without HF (AF/non-HF), AF/HF patients were older, more often male, more often had permanent AF, and had more comorbidities. Of AF/HF patients, 98% had class I indications to oral anticoagulation (OAC). Still, 16% of patients were not treated with OAC at hospital admission, and 9%-at discharge (regardless of the presence of HF and its subtypes). Of patients not receiving OAC upon admission, 61% were prescribed OAC (most often apixaban) at discharge. AF/non-HF patients more often converted from AF at admission to sinus rhythm at discharge compared to AF/HF patients (55% vs. 30%), despite cardioversion performed as often in both groups. Class I antiarrhythmics were more often prescribed in AF/non-HF than in AF/HF group (13% vs. 8%), but still as many as 15% of HFpEF patients received them. Over 70% of hospitalized AF patients have coexisting HF. A significant number of AF patients does not receive the recommended OAC.