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Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation.

Publication ,  Journal Article
Allen LaPointe, NM; Lokhnygina, Y; Sanders, GD; Peterson, ED; Al-Khatib, SM
Published in: Am Heart J
November 2013

BACKGROUND: Atrial fibrillation (AF) guideline recommendations for antiarrhythmic drugs (AADs) are based on the effectiveness and safety of the AAD in patients with selected, concomitant heart disease. It is unknown to what extent these recommendations are being implemented in clinical practice. METHODS: Using commercial health claims, patients with AF were identified and then categorized into mutually exclusive, guideline-established subgroups based on their most serious concurrent heart disease: heart failure, coronary artery disease (CAD), hypertension, and no heart disease. Antiarrhythmic drug use after the first AF encounter and the identified concurrent heart disease encounter was determined from prescription claims, and this was compared with guideline recommendations. RESULTS: From January 2006 through December 2010, a total of 331,274 patients with AF aged < 65 years were identified: 18%, heart failure; 23%, CAD; 33%, hypertension; and 25%, no heart disease. Of these, 78,877 (24%) patients filled ≥ 1 qualifying AAD prescription. The median age was 57 years (interquartile range 52-61), and 69% were male. A total of 74,191 patients had AADs after both the AF and concurrent heart disease encounters: 27% with heart failure, 25% with CAD, 21% with hypertension, and 19% with no heart disease. In the heart failure and CAD subgroups, 45% and 31% of AADs were inconsistent with first- or second-line guideline recommendations, respectively. CONCLUSION: More than one-third of the AADs used in patients with AF and CAD or heart failure did not conform to guideline recommendations. This highlights the potential need for increased clinician education and intervention to improve the safe use of AADs for AF management.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2013

Volume

166

Issue

5

Start / End Page

871 / 878

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Middle Aged
  • Male
  • Humans
  • Guideline Adherence
  • Female
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases
  • Atrial Fibrillation
  • Anti-Arrhythmia Agents
 

Citation

APA
Chicago
ICMJE
MLA
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Allen LaPointe, N. M., Lokhnygina, Y., Sanders, G. D., Peterson, E. D., & Al-Khatib, S. M. (2013). Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation. Am Heart J, 166(5), 871–878. https://doi.org/10.1016/j.ahj.2013.08.010
Allen LaPointe, Nancy M., Yuliya Lokhnygina, Gillian D. Sanders, Eric D. Peterson, and Sana M. Al-Khatib. “Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation.Am Heart J 166, no. 5 (November 2013): 871–78. https://doi.org/10.1016/j.ahj.2013.08.010.
Allen LaPointe NM, Lokhnygina Y, Sanders GD, Peterson ED, Al-Khatib SM. Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation. Am Heart J. 2013 Nov;166(5):871–8.
Allen LaPointe, Nancy M., et al. “Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation.Am Heart J, vol. 166, no. 5, Nov. 2013, pp. 871–78. Pubmed, doi:10.1016/j.ahj.2013.08.010.
Allen LaPointe NM, Lokhnygina Y, Sanders GD, Peterson ED, Al-Khatib SM. Adherence to guideline recommendations for antiarrhythmic drugs in atrial fibrillation. Am Heart J. 2013 Nov;166(5):871–878.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2013

Volume

166

Issue

5

Start / End Page

871 / 878

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Middle Aged
  • Male
  • Humans
  • Guideline Adherence
  • Female
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases
  • Atrial Fibrillation
  • Anti-Arrhythmia Agents