Current practice of antiarrhythmic drug therapy for prevention of atrial fibrillation in Europe: The European Heart Rhythm Association survey

Abstract

The aim of this survey was to provide insight into current practice regarding the use of antiarrhythmic drugs for atrial fibrillation (AF) among members of the European Heart Rhythm Association research network. Thirty-seven centres responded. Rhythm control was preferred in patients with significant AF-related symptoms by 73% of centres, in all patients after a first detected episode by 59%, and in young patients even if AF was well tolerated by 49% of centres. The most common strategy after successful conversion of the first AF episode was a 'wait-and-see' approach without initiation of antiarrhythmic drugs (49%). Conventional β-blockers were always or sometimes used as first-choice drugs for AF prevention by 76% of centres. Only 11% used dronedarone regularly as a first-choice drug. The diagnostic work-up for exclusion of heart disease prior to initiation of class IC antiarrhythmic drugs was limited. Markers monitored for proarrhythmia risk were QRS duration for class IC drugs (68%) and the QT interval for sotalol and amiodarone (65%). In conclusion, rhythm control is more widely employed than expected. Beta-blockers are widely used for AF prevention in contrast to the limited use of the new drug dronedarone.