Atrial Fibrillation III (AF III) Registry

Introduction

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia affecting approximately 2% of the general adult population. A systematic review of 184 worldwide population-based studies estimated that in 2010 the number of individuals with AF was 33.5 million [1], but the global prevalence of AF is probably underestimated due to limited data outside Europe and North America and ‘subclinical’ undiagnosed AF cases [1],[2]. In Europe, over six million individuals suffer from AF, and its prevalence is estimated to at least double in the next 50 years as the population ages.

The need for a new registry of AF clinical practice in Europe

Guideline-adherent therapy of AF has been shown to improve outcomes [4],[5], but the management of patients with AF in clinical practice sometimes may differ from evidence-based recommendations.

In 2016, the ESC published new guidelines on the management of AF [3]. A new one-year survey under the EORP programme would enable a timely assessment of the uptake and implementation of these new ESC guidelines in clinical practice and would inform us about outcomes related to contemporary guideline-adherent management of AF. The assessment of adherence to guidelines will allow for targeted education programmes in order to improve practices ("virtuous circle").

The design and protocol will be broadly similar to the previous protocol for the EHS-AF and EORP-AF Long-Term General AF Registry (see also AF General Long-Term page on this site) and compatible with other EORP programmes, in order to allow comparability of datasets, as well as additional modelling information on time trends, modelling of prevalence/incidence, cost and health economics, etc. This dataset could also be compared to published data from other recent AF surveys or registries (some funded by industry, some still ongoing) in Europe, such as AFNET, Record-AF, GARFIELD, GLORIA™-AF and others.

Objectives of the Registry

The general objectives of the EORP Registry on AF guidelines implementation in clinical practice are summarized as follows:

• Identification of contemporary patterns in AF management in practice, assessment of their compliance with the ESC AF Guidelines 2016 and identification of major gaps in the Guidelines implementation in clinical practice in order to facilitate their implementation in the daily management of AF patients.
• Characterisation of the clinical practice settings associated with good versus poor AF Guidelines implementation.
• Assessment and comparison of the outcome of guideline-adherent versus guideline non-adherent management strategies.

Aims for Immediate Analysis

Analysis of the frequency of a complete diagnostic workup concerning:

• Screening for AF
• Documentation of AF
• Underlying heart disease
• Other possible associated conditions
• Clinical type of AF
• Individual patient risk profile assessment
• Consequences of AF

Analysis of the frequency of guideline-adherent use of:

• Anti-thrombotic treatment
• Rate control measures
• Drugs in pharmacological cardioversion
• Electrical cardioversion
• AF ablation
• Therapies for maintenance of sinus rhythm
• Comprehensiveness of management of associated cardiovascular disease (particularly focusing on hypertension and coronary artery disease and systolic heart failure).

Analysis of the relationship between the management of AF and morbidity/mortality at 1 year.

Study Organisation

The Executive Committee

Tatjana S. Potpara (Serbia) is the Chairperson of this registry

Harry Crijns (the Netherlands)
Laurent Fauchier (France)
Gregory Y H Lip (United Kingdom)
Giuseppe Boriani (Italy)
Paulus Kirchhof (United Kingdom)
Nikolaos Dagres (Germany)Elena Arbelo (Spain)
Radoslaw Lenarczyk (Poland)
Irina Savelieva (United Kingdom)
Aldo Maggioni (Italy), Scientific Coordinator for EORP, non-voting

View all ongoing ESC Registries