Results of the Euro Heart Survey on atrial fibrillation (AF), demonstrate that many AF patients receive clot-preventing drugs while not at risk for stroke.
Also, patients are given rhythm control drugs despite the fact that they never were symptomatic. These drugs may induce intracranial bleeding as well as sudden death, respectively. Insight into the data of this survey may help reducing redundant and potentially dangerous treatments in AF patients.
AF is a frequent disorder occurring particularly in elderly patients. It may be secondary to hypertension, coronary artery disease, heart failure or valvular heart disease, but it can also occur in patients without heart disease. In 2004 a survey on AF was conducted in 182 centers from 35 ESC countries. Data was collected on characteristics and management of 5334 patients.
Since patients with AF have an increased risk for stroke, clot-preventing drugs are recommended. Yet, the survey revealed that 34% of 4279 eligible patients did not receive these agents. 559 patients were found to have a low stroke risk. Of these patients 55% were prescribed vitamin K antagonists by their doctor, their average age was 54 years. This clearly indicates overuse of this potentially dangerous drug. In this case, overuse either relates to inappropriate application of risk stratification schemes and maybe also to fear for stroke in the young with AF.