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Treatment strategy and clinical outcome in Japanese patients with atrial fibrillation

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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.

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Authors and Affiliations

  1. Department of Clinical Epidemiology & Systems, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Shinya Suzuki & Tsutomu Yamazaki

  2. The Cardiovascular Institute, Roppongi 7-3-10, Minato-ku, Tokyo, 106-0032, Japan

    Takeshi Yamashita, Takayuki Otsuka, Koichi Sagara, Tokuhisa Uejima, Yuji Oikawa, Junji Yajima, Akira Koike, Kazuyuki Nagashima, Hajime Kirigaya, Ken Ogasawara, Hitoshi Sawada & Tadanori Aizawa

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  1. Shinya Suzuki
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  2. Takeshi Yamashita
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  3. Takayuki Otsuka
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  4. Koichi Sagara
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  5. Tokuhisa Uejima
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  6. Yuji Oikawa
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  7. Junji Yajima
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  8. Akira Koike
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  9. Kazuyuki Nagashima
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  10. Hajime Kirigaya
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  11. Ken Ogasawara
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  12. Hitoshi Sawada
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  13. Tsutomu Yamazaki
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  14. Tadanori Aizawa
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Correspondence to Shinya Suzuki.

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Suzuki, S., Yamashita, T., Otsuka, T. et al. Treatment strategy and clinical outcome in Japanese patients with atrial fibrillation. Heart Vessels 24, 287–293 (2009). https://doi.org/10.1007/s00380-008-1121-2

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  • DOI: https://doi.org/10.1007/s00380-008-1121-2

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