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CLINICAL AND STATISTICAL EVALUATION OF THE CALLS OF PATIENTS WITH ATRIAL FIBRILLATION

https://doi.org/10.20514/2226-6704-2018-8-5-389-393

Abstract

This article presents the results of the clinical and statistical evaluation of the calls of patients with atrial fibrillation (AF) by the data of the emergency medical service in Moscow. Ambulance teams was performed a voluntary questionnaire survey of 5003 patients with AF. There were 17% of emergency calls for heart rhythm disturbances from the total number of cardiovascular diseases and 88% of these arrhythmias was AF. A clear trend was observed in the prevalence of AF in men of working age and in women in the older age group. Among the respondents prevails paroxysmal form of AF in 70.1% of cases. The average score on the risk scale of thromboembolic complications in patients with atrial fibrillation/flutter CHA2DS2-VASc was 3.56±1.71. The average score on the scale of risk assessment of ischemic stroke in patients with nonrheumatic atrial fibrillation/flutter CHADS2 was 1.85±1.13. The number of patients with a score of two or more on both scales was 87.7% and 59.3% respectively. 28% of patients with AF asked for medical help at least 48 hours after the onset of the paroxysm. Regular observation by a cardiologist is carried out in 50.5% of cases, by a therapist in 62.8%, jointly by a therapist and a cardiologist in 45% respectively. Continuous oral anticoagulant therapy is performed in 29.8% of patients with AF. The percentage of medical evacuations of patients with AF increased from 23.8% in 2015 to 27.1% in 2016. The study showed that regular clinical and statistical analysis of the effectiveness of medical care for patients with AF at all stages of medical surveillance is necessary.

About the Authors

N. F. Plavunov
Federal State budget institution of higher education A.I. Yevdokimov Moscow State University of Medicine and Dentistry; First aid station named after A.S. Puchkov.
Russian Federation
Moscow.


N. I. Gaponova
Federal State budget institution of higher education A.I. Yevdokimov Moscow State University of Medicine and Dentistry; First aid station named after A.S. Puchkov.
Russian Federation
Moscow.


V. A. Kadyshev
Federal State budget institution of higher education A.I. Yevdokimov Moscow State University of Medicine and Dentistry; First aid station named after A.S. Puchkov.
Russian Federation
Moscow.


V. R. Abdrachmanov
Federal State budget institution of higher education A.I. Yevdokimov Moscow State University of Medicine and Dentistry.
Russian Federation
Moscow.


A. E. Akimov
Federal State budget institution of higher education A.I. Yevdokimov Moscow State University of Medicine and Dentistry; First aid station named after A.S. Puchkov.
Russian Federation
Moscow.


A. I. Kulik
First aid station named after A.S. Puchkov.
Russian Federation
Moscow.


References

1. Medical and demographic indices of the Russian Federation in 2014. Statistical Handbook. M, 2014; 186 р. [In Russian].

2. Diagnosis and treatment of atrial fibrillation. Recommendations RSC, RSSA, ACVS. Russian journal of cardiology. 2013; 4: 1-100 [In Russian].

3. P. Kirchhof, S.Benussi, Dipak Kotecha et al. 2016 ESC Guidelines forthe management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016.

4. Aksnes T.A., Kjeldsen S.A. A link between hypertension and atrial fibrillation: methods of treatment and prevention. Curr Vasc Pharmac. 2010; 6: 769-774.

5. Sun Y, Hu D. The link between diabetes and atrial fibrillation: cause or correlation? J. Cardiovascular Dis 2010; 10-11.

6. Heeringa J., van der Kuip D.A., Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Roterdam study. Eur Heart J. 2006; 27: 949-953.

7. Grond M., Jauss M., Hamann G., Stark E., Veltkamp R., Nabavi D., Horn M., Weimar C., Kohrmann M., Wachter R., Rosin L., Kirchhof P. Improved detection of silent atrial fibrillation using 72 hour Holter ECG in patients with ischemic stroke: a prospective multicenter cohort study. Stroke. 2013; 44: 3357-3364.

8. Nabauer M., Gerth A., Limbourg T et al. The Registry of the German Competence NET work on Atrial Fibrillation: patient characteristics and initial management. Europace. 2009; 11: 423-434.

9. Hart R.G., Pearce L.A., Aguilar M.I. Metaanalysis: antithrombotic therapy to prevent stroke in patients who have non valvular atrial fibrillation. Ann Intern Med. 2007; 146: 857-867.

10. Connolly S.J., Ezekowitz M.D., Yusuf S., et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Eng J Med. 2009; 361: 1139-1151.

11. ROCKET AF Study investigators6 rivaroxaban– once daily, oral, direct factor xa inhibition compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation6 rationale and design of the ROCKET AF study. Amer Heart J. 2010;159: 340-347.

12. Lopes R.D., Alexander J.H., Al-Khatib S.M., et al. Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial: design and rationale. Amer Heart J. 2010; 159: 331-339.

13. Chugh S.S., Blackshear J.L., Shen W.K. et al. Epidemiology and natural history of atrial fibrillation: clinical implications. J Amer Coll Card. 2001; 37: 371-378.

14. Kirchhof P., Auricchio A., Bax J., et al. Outcome parameters for trials in atrial fibrillation: executive summary. Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NET work (AFNET) and the European Heart Rhythm Association (EHRA). Eur Heart J. 2007; 28: 2803–2817.

15. Colilla S., Grow A., Petkun W, et al. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Amer J Cardiol. 2013; 112: 1142-1147.

16. Mc Murrau J., Adamopoulos S., Anker S. ESC guidelines for the diagnosis and treatment of acute and chronic heart faiture 2012. Eur Heart J. 2012; 33: 1787- 1847.


Review

For citations:


Plavunov N.F., Gaponova N.I., Kadyshev V.A., Abdrachmanov V.R., Akimov A.E., Kulik A.I. CLINICAL AND STATISTICAL EVALUATION OF THE CALLS OF PATIENTS WITH ATRIAL FIBRILLATION. The Russian Archives of Internal Medicine. 2018;8(5):389-393. https://doi.org/10.20514/2226-6704-2018-8-5-389-393

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ISSN 2226-6704 (Print)
ISSN 2411-6564 (Online)