Traitement préventif des récidives de fibrillation atriale en médecine cardiologique de ville : données de l'observatoire FAUVE

Abstract

Objectives. – Analyse the modalities of preventive therapy of recurrences of paroxysmal or persistent atrial fibrillation (AF) with Vaughan–Williams (VW) type IC antiarrhythmics. Methods. – Observational study conducted with 326 French cardiologists established in general office practice, involving on the one hand an opinion survey among the cardiologists and on the other hand a cross-sectional observatory of usual medical practice. Each cardiologist was asked to include two patients aged less than 65 with non-permanent (paroxysmal or persistent) AF without left ventricle dysfunction (LVD) and initiated on treatment with a VW type IC antiarrhythmic after cardioversion to sinus rhythm. Results. – The opinion survey among the cardiologists indicates that non-permanent AF constitutes 36.1% of AF cases, of which 57.8% concern LVD-free patients. Most cardiologists (85%) declare to institute a preventive therapy of AF recurrences in 70–100% of these patients after cardioversion to sinus rhythm, with a VW type IC antiarrhythmic in more than 50% of cases. Of the 633 patients included in the FAUVE observatory, mainly men, 409 (64.6%) had paroxysmal AF and 224 (35.4%) had persistent AF. Analysis of therapeutic management shows that both alteration of the previous treatment and the choice of a VW type IC antiarrhythmic are based chiefly on efficacy and on tolerability of the antiarrhythmic therapy. Conclusion. – VW type IC antiarrhythmics constitute a therapy of choice for the maintenance of sinus rhythm in non-aged and LVD-free patients with non-permanent AF.