State of medical care for patients with atrial fibrillation in Germany - AFNET registry

Gerth A, Nabauer M, Limbourg T, Meinertz T, Oeff M, Kirchhof P, Treszl A, Wegscheider K, Breithardt G, Steinbeck G

Abstract

Atrial fibrillation is the most common clinically relevant arrhythmia and carries a five-fold increase in embolic stroke risk. In order to obtain an impression of current diagnostic and therapeutic decisions as well as long term complications and prognosis in patients with atrial fibrillation in Germany, a patient registry was established in 2003 within the German AFNET. Initial results indicate that the overall rate of oral anticoagulation is comparable to results from other registries on atrial fibrillation in Europe. Most notably, patients aged 70 years and older frequently do not receive a required oral anticoagulation. The clinical stroke risk stratification scheme, CHADS(2)-score, has only a minor impact on the decision to provide anticoagulation in daily clinical practice. The observed differences in anticoagulation rate in specialized cardiac care centres as compared to non-specialized centres could only be in part explained by differences in age of the patients and concomitant health conditions. It is concluded that oral anticoagulation remains underused in the prevention of ischemic stroke in atrial fibrillation in Germany.