Heart and Vessels

, Volume 24, Issue 4, pp 287–293

Treatment strategy and clinical outcome in Japanese patients with atrial fibrillation

Authors

    • Department of Clinical Epidemiology & Systems, Graduate School of Medicinethe University of Tokyo
  • Takeshi Yamashita
    • The Cardiovascular Institute
  • Takayuki Otsuka
    • The Cardiovascular Institute
  • Koichi Sagara
    • The Cardiovascular Institute
  • Tokuhisa Uejima
    • The Cardiovascular Institute
  • Yuji Oikawa
    • The Cardiovascular Institute
  • Junji Yajima
    • The Cardiovascular Institute
  • Akira Koike
    • The Cardiovascular Institute
  • Kazuyuki Nagashima
    • The Cardiovascular Institute
  • Hajime Kirigaya
    • The Cardiovascular Institute
  • Ken Ogasawara
    • The Cardiovascular Institute
  • Hitoshi Sawada
    • The Cardiovascular Institute
  • Tsutomu Yamazaki
    • Department of Clinical Epidemiology & Systems, Graduate School of Medicinethe University of Tokyo
  • Tadanori Aizawa
    • The Cardiovascular Institute
Original Article

DOI: 10.1007/s00380-008-1121-2

Cite this article as:
Suzuki, S., Yamashita, T., Otsuka, T. et al. Heart Vessels (2009) 24: 287. doi:10.1007/s00380-008-1121-2

Abstract

Many large-scale randomized control trials (RCTs) have been performed regarding treatment strategy in atrial fibrillation (AF) in Western countries and also in Japan. However, limited data are available concerning real-world relationships between the treatment strategy and prognosis of AF patients. Out of a prospective cohort of The Shinken Database 2004 (n = 2 412), 286 AF patients (male 205, 64.1 ± 12.3 years, paroxysmal form 165) were retrospectively investigated. The percentage of AF patients under the rhythm control strategy was evaluated using the Kaplan-Meier method, which showed the cumulative proportion of rhythm control strategy was ∼30% at the 90th day after the initial visit and 40.0% at 1 year. The average time to the first rhythm control strategy was 68.3 ± 106.7 days. Those under rhythm control strategy were associated with fewer coexisting organic cardiac diseases, a younger age, and smaller left atrial dimension. Consequently, they showed very good prognosis (cumulative incidence rate of cardiovascular events at 1 year was 0.0%). Careful induction of rhythm control strategy, which was adopted in ∼40% of the patients in the real world, was associated with fewer comorbidities and therefore might lead to better prognosis, although this does not mean the direct effects of rhythm control strategy.

Key words

Atrial fibrillationPrognosisRhythm controlEpidemiologyMorbidity
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Copyright information

© Springer Japan 2009