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Management of atrial fibrillation in patients with chronic kidney disease in Europe Results of the European Heart Rhythm Association Survey.
- Source :
- EP: Europace; 12/1/2015, Vol. 17 Issue 12, p1862-1867, 6p
- Publication Year :
- 2015
-
Abstract
- The purpose of this European Heart Rhythm (EHRA) Scientific Initiatives Committee EP Wire Survey was to assess 'real-world' practice in the management of patients with atrial fibrillation (AF) and chronic kidney disease (CKD) in the European Eelectrophysiology centres. Of 41 responding centres, 39 (95.1%) and 37 (90.2%) routinely evaluated renal function in AF patients at first presentation and during follow-up, respectively, but 13 centres (31.7%) re-assessed advanced CKD only at ≥1-year intervals. While the use of oral anticoagulants (OACs) in mild-to-moderate CKD patients was mostly guided by individual patient stroke risk, 31% of the centres used no therapy, or aspirin or the left appendage occlusion in patients with advanced CKD and HAS-BLED ≥ 3. Vitamin K antagonists (VKAs) were preferred in patients with severe CKD or under renal replacement therapy (RRT), any non-VKA in patients with mild CKD, and apixaban in patients with moderate CKD. Rhythm control was preferred in patients with mild-to-moderate CKD (48.7% of centres), and rate control in patients with severe CKD (51.2% of centres). In 20 centres (48.8%), AF ablation was not performed in advanced CKD patients. Most centres performed AF ablation on OAC, but heparin bridging was still used in >10% of centres. Our survey has shown that the importance of renal function monitoring in AF patients is well recognized in clinical practice. In patients with mild-to-moderate CKD, AF is mostly managed according to the guideline recommendations, but more data are needed to guide the management of AF in patients with severe CKD or RRT. [ABSTRACT FROM AUTHOR]
- Subjects :
- ATRIAL fibrillation diagnosis
ATRIAL fibrillation treatment
TREATMENT of chronic kidney failure
CHRONIC kidney failure
CHRONIC kidney failure complications
STROKE prevention
STROKE diagnosis
ANTICOAGULANTS
ATRIAL fibrillation
CATHETER ablation
COMPARATIVE studies
DRUG administration
HEALTH services accessibility
HEALTH status indicators
KIDNEY function tests
RESEARCH methodology
MEDICAL cooperation
MEDICAL protocols
ORAL drug administration
RESEARCH
STROKE
SURVEYS
EVALUATION research
TREATMENT effectiveness
SEVERITY of illness index
DISEASE complications
DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 10995129
- Volume :
- 17
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- EP: Europace
- Publication Type :
- Academic Journal
- Accession number :
- 112133460
- Full Text :
- https://doi.org/10.1093/europace/euv416