| Objective:To investigate the First Affiliated Hospital of Sun Yat-Sen University the age distribution of hospitalized patients with atrial fibrillation and etiology (or factors) characteristics, the type of relationship with the left atrial fibrillation and cardiac function, the status treatment of atrial fibrillation (including transfer reuse and maintenance of sinus rhythm, ventricular rate control, prevention of thromboembolism and atrial fibrillation upstream medication), expect to be able to provide a reference for future work in clinical drug therapy in patients hospitalized with atrial fibrillation.Methods:A retrospective case analysis, the January 1,2010 to December 31, 2014 at the First Affiliated Hospital of Sun Yat-Sen University in the heart of an inpatient and diagnostic investigation for patients with atrial fibrillation, in which patients are hospitalized repeatedly Finally, once a diagnosis of atrial fibrillation in hospital data subject, I do not count the number of hospitalizations. Diagnosis is based on ECG or Holter or intracardiac electrophysiology. Detailed records of the basic characteristics of hospitalized patients with atrial fibrillation, atrial fibrillation causes and risk factors for, thromboembolic complications and drug treatment were analyzed statistically. Establish a database of patients with atrial fibrillation, using SPSS18.O statistical software for data analysis, count data normally distributed with mean± standard deviation, count data use chi-square test, P<0.05 was considered statistically significant.The results:(a) General information:1. Registered a total of 1031 cases of atrial fibrillation, the male 547 cases (53.1%), female 484 cases (46.9%); the proportion of male and female patients was 1.1:1; mean age 66 years (16,98 years), the proportion of patients with atrial fibrillation increases with age, the proportion of 65 to 85-year-old patients (52.8%), consistent with the literature, of which 70 to 79 age group the largest proportion (29.5%).2. Paroxysmal atrial fibrillation 435 cases (42.2%),596 cases of chronic atrial fibrillation (57.8%), of which 246 cases of persistent (23.8%),350 cases of permanent (34.0%).3. The main cause of atrial fibrillation by hypertension 302 cases (29.2%),279 cases of coronary heart disease (27.1%),141 cases of rheumatic heart disease (13.7 percent).(B) the rate and rhythm control:1, investigated mainly in patients with atrial fibrillation rate control based,758 (73.5%), including chronic atrial fibrillation patients with ventricular rate control were 475 cases, accounting for 79.7% of the total, compared with paroxysmal atrial fibrillation patients with ventricular rate control are accounted for the proportion of the total (60.1%) higher.2, β-blockers in patients with atrial fibrillation in the survey hypertension, coronary heart disease, heart failure patients with a higher proportion of applications, respectively accounting for 62.3% of these patients,78.1%,86.9%, in isolated AF reached 53.2% in the proportion of applications, while the highest proportion of digitalis in heart failure patients,44.6% fewer non-dihydropyridine calcium antagonists universal application. 3, a total of 1024 cases (99.3%) patients with a resting heart rate reaches the target value, of which 937 cases (90.9%) reached the strict control of ventricular rate in AF target. Resting heart rate standard drugs used mainly for β-blockers and digitalis drugs were 638 cases (92.1%),255 cases (87.0%).4, the use of drugs for cardioversion were 247 cases (29.4%), which pharmacologic cardioversion of paroxysmal atrial fibrillation in patients with a high proportion of 39.3%(171/435), and pharmacologic cardioversion in patients with chronic atrial fibrillation a lower proportion accounted for 12.8%(76/596).5, the CPC 165 cases in this study (16%) patients underwent radiofrequency ablation of atrial fibrillation, in which 133 cases (80.6%) for paroxysmal atrial fibrillation,32 cases (19.4%) in patients with chronic atrial fibrillation, with an average age of 65.8±13.6 years (20,82) to female ratio was 101: 64,the mean left atrial size was 45.8±11.3mm.(C) anti-thrombotic therapy:1,125 cases of patients surveyed (12.1%) patients did not give any anti-thrombotic drugs; 376 cases (36.5%) were treated with anti-platelet therapy; 505 cases (49.0%) were treated with anti-coagulation treatment, warfarin anti-coagulation 475 cases (46.1%), given rivaroxaban or dabigatran anticoagulant treatment of 30 cases (2.9%). Anticoagulant, anti-platelet aggregation group and no anti-thrombotic group embolism events in patients with a total of 121 cases, accounting for 11.7% of all enrolled patients, the warfarin group,64 cases,49 cases in the aspirin group, no anti-thrombotic 8 patients,3 Group embolism event rates were 12.7%,13.0%,6.4%.2, only (144/475) of 30.3% of patients with atrial fibrillation INR target range of China reached a consensus,42.1%(200/475) of patients with atrial fibrillation INR is between 1.5-2.5.27.6%(131/475) INR values in patients with less than 1.5.(D) upstream therapy:a drug for the treatment of 1048 cases of patients with atrial fibrillation upstream conduct individual statistics, β-blockers 693 cases (67.2%), the application of statins 518 cases (50.2%), ARB class of 450 cases (43.6%), spironolactone 338 cases (32.8%), ACEI class 171 cases (16.6%).2. hypertension, coronary heart disease, valvular heart disease and in patients with lone atrial fibrillation, the upper reaches of the drug mainly in P-blockers, statins, ARB class of drugs based; patients with heart failure mainly P-blockers, spironolactone, statins, ARB class of drugs as the upstream treatment.Conclusion:1,1031 cases of atrial fibrillation, the proportion of atrial fibrillation increases with age, from 70 to 79 age group the largest proportion of 29.5%. Grouped by gender, at <80 years of age in each group, more common in men, and ≥80 years of age in each group, the proportion of women is slightly higher than men.2, with the change of cardiovascular disease spectrum, hospitalized patients with atrial fibrillation cause significant changes in constituent ratio, the proportion of rheumatic heart disease, atrial fibrillation was significantly decreased, hypertension, coronary heart disease, valvular degeneration elderly, lone atrial fibrillation, an increase in the proportion of cardiomyopathy.3, mainly in patients with atrial fibrillation surveyed room rate control based,758 (73.5%). The use of drugs for cardioversion were 247 cases (29.4%). A total of 165 cases (16%) patients underwent radiofrequency ablation of atrial fibrillation.4, there are 87.9% of non-valvular atrial fibrillation patients with anti-thrombotic therapy, the use of anti-coagulation therapy proportion of 40.1%, the majority of patients with anti-platelet therapy. Low intensity of anti-coagulation.5, hypertension, coronary heart disease, valvular heart disease and in patients with lone atrial fibrillation, the upper reaches of the drug mainly in β-blockers, statins, ARB class of drugs based; patients with heart failure mainly β-blockers, spironolactone, statins, ARB class of drugs as the upstream therapy. The proportion of upstream therapy applications still to be improved. |
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