Characteristics and Treatment of Atrial Fibrillation with Respect to the Presence or Absence of Heart Failure. Insights from the Multicenter Polish Atrial Fibrillation (POL-AF) Registry.
BACKGROUND
We aimed to assess characteristics and treatment of AF patients with and without heart failure (HF).


METHODS
The prospective, observational Polish Atrial Fibrillation (POL-AF) Registry included consecutive patients with AF hospitalized in 10 Polish cardiology centers in 2019-2020.


RESULTS
Among 3999 AF patients, 2822 (71%) had HF (AF/HF group). Half of AF/HF patients had preserved ejection fraction (HFpEF). Compared to patients without HF (AF/non-HF), AF/HF patients were older, more often male, more often had permanent AF, and had more comorbidities. Of AF/HF patients, 98% had class I indications to oral anticoagulation (OAC). Still, 16% of patients were not treated with OAC at hospital admission, and 9%-at discharge (regardless of the presence of HF and its subtypes). Of patients not receiving OAC upon admission, 61% were prescribed OAC (most often apixaban) at discharge. AF/non-HF patients more often converted from AF at admission to sinus rhythm at discharge compared to AF/HF patients (55% vs. 30%), despite cardioversion performed as often in both groups. Class I antiarrhythmics were more often prescribed in AF/non-HF than in AF/HF group (13% vs. 8%), but still as many as 15% of HFpEF patients received them.


CONCLUSIONS
Over 70% of hospitalized AF patients have coexisting HF. A significant number of AF patients does not receive the recommended OAC.
['Gawałko|Monika|M|', 'Budnik|Monika|M|', 'Gorczyca|Iwona|I|', 'Jelonek|Olga|O|0000-0002-2179-9945', 'Uziębło-Życzkowska|Beata|B|0000-0001-8997-6568', 'Maciorowska|Małgorzata|M|0000-0001-5242-7522', 'Wójcik|Maciej|M|0000-0002-5092-7811', 'Błaszczyk|Robert|R|0000-0003-1853-5006', 'Tokarek|Tomasz|T|', 'Rajtar-Salwa|Renata|R|', 'Bil|Jacek|J|0000-0002-8724-5611', 'Wojewódzki|Michał|M|', 'Szpotowicz|Anna|A|', 'Krzciuk|Małgorzata|M|', 'Bednarski|Janusz|J|0000-0001-6359-0202', 'Bakuła-Ostalska|Elwira|E|', 'Tomaszuk-Kazberuk|Anna|A|', 'Szyszkowska|Anna|A|', 'Wełnicki|Marcin|M|0000-0002-7454-521X', 'Mamcarz|Artur|A|0000-0002-9569-1486', 'Kapłon-Cieślicka|Agnieszka|A|']
atrial fibrillation heart failure anticoagulation