Management of patients with atrial fibrillation by primary-care physicians in Germany: 1-year results of the ATRIUM registry

BACKGROUND: Patients with atrial fibrillation (AF) in Germany are often managed jointly by primary-care physicians in cooperation with cardiologists. We aimed to investigate the management and 1-year outcomes of AF patients in this setting.

HYPOTHESIS: We set out to describe the current management of AF patients in primary care settings in Germany.

METHODS: Observational registry with 1-year follow-up, performed by a representative, randomly selected sample of 781 primary-care physicians in Germany.

RESULTS: Of 3781 patients with electrocardiographically documented AF, 3163 patients (age 71.9 ± 9.2 years, 57.9% males) were followed for 1 year; 28.4% had paroxysmal, 27.0% persistent, and 43.3% permanent AF. Comorbid conditions were common (mean CHA₂DS₂-VASc score 3.8 ± 1.7). Rhythm-control therapy was used in 16.4%. Although oral anticoagulation was often used (82.7% at baseline), stroke rate during follow-up was high (2.7% stroke, 3.0% transient ischemic attack). Despite a long duration of AF (mean duration 61 months at enrollment), 18.5% of patients were hospitalized during the 1-year follow-up.

CONCLUSIONS: In this unselected group of patients with long-standing AF managed in primary care, hospitalizations and cardiovascular complications including strokes are frequent, illustrating the need to improve management of AF patients.