Identifying temporal changes to the prescribing of anti-arrhythmics for atrial fibrillation

Publication Type:
Journal Article
Citation:
Journal of Pharmacy Practice and Research, 2010, 40 (4), pp. 285 - 289
Issue Date:
2010-01-01
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Background: There are a paucity of data on the use of anti arrhythmics for a trial fibrillation (AF), particularly in view of new treatment guidelines recommending rate control over rhythm control. Aim: To investigate the use of anti-arrhythmics for AF in the local clinical setting. Method: A retrospective clinical audit of the medical records of 174 adult patients with primary or secondary AF was conducted at a large Sydney teaching hospital. Data were collected on patients' characteristics, medical history, factors affecting treatment choice and clinical outcomes. Results: For acute treatment of AF, 38 (22%) patients received rhythm control only, 30 (17%) received rate control only, and 42 (24%) received rate control plus rhythm control. For longterm management of AF, 24 (14%) patients received rhythm control only, 42 (24%) received rate control only, and 28 (16%) received rate control plus rhythm control. The number of patients who attained sinus rhythm was higher in those receiving rhythm control drugs versus rate control drugs (84% vs 31%; p < 0.05). A decrease was observed in the number of patients on digoxin (41% vs 6%; p < 0.01) and amiodarone (26% vs 6%; p < 0.001). Factors identified as influencing treatment choice were age, heart rate, AF characteristics and comorbidities. Conclusion: There has been a temporal change in the use of anti-arrhythmics for AF, reflecting changes to recommendations on the use of rhythm versus rate control drugs. These changes in prescribing patterns are reflective of current guidelines and evidence-based practice.
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