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Symptom management strategies: rhythm versus rate control in patients with atrial fibrillation in the Balkan region: Data from the BALKAN-AF Survey
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  • Monika Kozieł,
  • Miroslav Mihajlovic,
  • Milan Nedeljkovic,
  • Nikola Pavlovic,
  • Vilma Paparisto,
  • Ljilja Music,
  • Elina Trendafilova,
  • Anca Rodica Dan,
  • Zumreta Kusljugic,
  • Gheorghe-Andrei Dan,
  • Gregory Lip,
  • Tatjana Potpara
Monika Kozieł
University of Liverpool
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Miroslav Mihajlovic
University of Belgrade
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Milan Nedeljkovic
University of Belgrade
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Nikola Pavlovic
Clinical Center Sestre Milosrdnice
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Vilma Paparisto
University Hospital Center 'Mother Teresa'
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Ljilja Music
University Clinical Center of Montenegro
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Elina Trendafilova
National Heart Hospital
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Anca Rodica Dan
Colentina University Hospital
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Zumreta Kusljugic
University Clinical Center Tuzla
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Gheorghe-Andrei Dan
"Carol Davila" University of Medicine
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Gregory Lip
University of Liverpool
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Tatjana Potpara
University of Belgrade
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Abstract

Background Symptom-focused management is one of the cornerstones of optimal atrial fibrillation (AF) therapy. Objectives To evaluate the use of rhythm control and rate control strategy. Second, to identify predictors of the use of amiodarone in patients with rhythm control and of the use of rhythm control strategy in patients with paroxysmal AF in the Balkans. Methods Prospective enrolment of consecutive patients from 7 Balkan countries to the BALKAN-AF survey was performed. Results Of 2,712 enrolled patients, 2,522 (93.0%) with complete data were included: 1,622 (64.3%) patients were assigned to rate control strategy and 900 (35.7%) to rhythm control. Patients with rhythm control were younger, more often hospitalized for AF and with less comorbidities (all p <0.05) than those with rate control. Symptom score [European Heart Rhythm Association (EHRA)] was not an independent predictor of a rhythm control strategy [odds ratio (OR) 0.99, 95% confidence interval (CI) 0.90-1.10, p = 0.945]. The most commonly chosen antiarrhythmic agents were amiodarone (49.7%), followed by propafenone (24.3%). Conclusion More than one third of patients in BALKAN-AF survey received a rhythm control strategy, and these patients tended to be younger with less comorbidities than those managed with rate control. EHRA symptom score is not significantly associated with rhythm control strategy. The most commonly used antiarrhythmic agents were amiodarone, followed by propafenone.

Peer review status:Published

27 Oct 2020Submitted to International Journal of Clinical Practice
28 Oct 2020Submission Checks Completed
28 Oct 2020Assigned to Editor
09 Nov 2020Reviewer(s) Assigned
24 Nov 2020Review(s) Completed, Editorial Evaluation Pending
16 Dec 20201st Revision Received
18 Dec 2020Submission Checks Completed
18 Dec 2020Assigned to Editor
18 Dec 2020Reviewer(s) Assigned
17 Jan 2021Review(s) Completed, Editorial Evaluation Pending
19 Jan 20212nd Revision Received
21 Jan 2021Assigned to Editor
21 Jan 2021Submission Checks Completed
21 Jan 2021Reviewer(s) Assigned
01 Feb 2021Review(s) Completed, Editorial Evaluation Pending
03 Feb 2021Editorial Decision: Accept
15 Feb 2021Published in International Journal of Clinical Practice. 10.1111/ijcp.14080