HRS: A-fib anticoagulant use surges, anti-arrhythmics remain flat

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DENVER—The number of antithrombotic agents administered to atrial fibrillation (AF) patients between 1992 and 2008 has surged; however, more evidence outlining the clinical benefits of anti-arrhythmic drugs is needed, according to a poster presentation featured here yesterday at the 31st annual Heart Rhythm Society scientific sessions.

Researchers from the University of Virginia Health System’s AF Center in Charlottesville, Va., used facility data recorded between 2004 and 2008 to analyze medication usage and administration in AF patients who presented for an initial visit.

“We know that patients who have AF are at risk for stroke and one of the most important things is that patients be on appropriate anticoagulant medications to prevent that,” Pamela K. Mason, MD, lead author of the study, told Cardiovascular Business News.

Overall, Mason and colleagues analyzed data of 1,664 AF patients who had an average age of 64 years, 32 percent were women and 10 percent were diagnosed with AF for more than 12 years.

Research trends in 1992 showed that only 10 percent of these AF patients were administered anticoagulant medications. “This is because back then this was relatively new information,” she said.

Comparatively, in 2008, over 80 percent of patients were administered and treated with anticoagulant drugs.

Research also showed that the number of patients administered rate control drugs by referring physicians was 65.5 percent, while 33.6 percent were were issued rhythm control drugs.

Mason attributed the swell of drug treatment to the clinical trials which arose in the early 1990s.

“There were a number of trials that showed that anticoagulation prevented stroke, which likely plays into these numbers,” she said.

Additionally, Mason said that “rate controlling medications went up dramatically." However, increases in anti-arrhythmic medication use was not as shocking."

In 2002, two clinical trials showed that AF patients did not do as well on anti-arrhythmic therapy. “This may account for why these numbers plateaued in 2004,” said Mason.

Additionally, Mason said that few anti-arrhythmic drugs have flowed onto the market and referred to anti-arrhythmic therapy options as the “wild card."

Mason explained the lapse in the physician administration of anti-arrhythmic drugs may be due to the fact that data on their benefits are scant.

We speculate that antithrombotic medication usage is going to remain high,” said Mason. “We hope it does because we know it benefits patients.… [W]e know that these drugs are linked to the fewer number of patient strokes,” she concluded.