Table 2.
Atrial Fibrillation Management According to Provider Specialty
| Variable | Overall (n=10 097), n (%) | Internal Medicine/Primary Care (n=1969), n (%) | Cardiology (n=6584), n (%) | Electrophysiology (n=1544), n (%) | P Value |
|---|---|---|---|---|---|
| Rate control | 6859 (67.9) | 1388 (70.5) | 4615 (70.1) | 856 (55.4) | <0.0001 |
| Rhythm control | 3202 (31.7) | 566 (28.8) | 1953 (29.7) | 683 (44.2) | |
| Prior cardioversion | 3037 (30.1) | 503 (25.6) | 1887 (28.7) | 647 (41.9) | <0.0001 |
| 1 | 1790 (58.9) | 313 (62.2) | 1138 (60.3) | 339 (52.4) | <0.0001 |
| 2 | 726 (23.9) | 118 (23.5) | 448 (23.7) | 160 (24.7) | |
| ≥3 | 513 (16.9) | 72 (14.3) | 294 (15.6) | 147 (22.7) | |
| Prior antiarrhythmic drug therapy | 4573 (45.3) | 847 (43.0) | 2824 (42.9) | 902 (58.4) | <0.0001 |
| 1 | 2939 (64.3) | 568 (67.1) | 1788 (63.3) | 583 (64.6) | <0.0001 |
| 2 | 923 (20.2) | 159 (18.8) | 549 (19.4) | 215 (23.8) | |
| ≥3 | 368 (8.1) | 71 (8.4) | 203 (7.2) | 94 (10.4) | |
| Prior warfarin therapy | 8256 (81.8) | 1532 (77.8) | 5403 (82.1) | 1321 (85.6) | <0.0001 |
| Catheter ablation of AF | 552 (5.5) | 100 (5.1) | 320 (4.9) | 132 (8.6) | <0.0001 |
| Surgical/hybrid maze | 194 (1.9) | 32 (1.6) | 104 (1.6) | 58 (3.8) | <0.0001 |
| AV node ablation | 220 (2.2) | 34 (1.7) | 142 (2.2) | 44 (2.9) | 0.0778 |
| Rate control agents | |||||
| Beta‐blocker | 6449 (63.9) | 1161 (59.0) | 4270 (64.9) | 1018 (65.9) | <0.0001 |
| Dihydropyridine CCB | 1391 (13.8) | 315 (16.0) | 884 (13.4) | 192 (12.4) | 0.0034 |
| Digoxin | 2361 (23.4) | 445 (22.6) | 1609 (24.4) | 307 (19.9) | 0.0005 |
| Antiarrhythmic drug therapy | 2895 (28.7) | 480 (24.4) | 1785 (27.1) | 630 (40.8) | <0.0001 |
| Amiodarone | 1002 (9.9) | 167 (8.5) | 625 (9.5) | 210 (13.6) | <0.0001 |
| Dronedarone | 466 (4.6) | 68 (3.5) | 320 (5.0) | 78 (5.1) | 0.0231 |
| Dofetilide | 190 (1.9) | 21 (1.1) | 93 (1.4) | 76 (4.9) | <0.0001 |
| Flecainide | 290 (2.9) | 55 (2.8) | 145 (2.2) | 90 (5.8) | <0.0001 |
| Propafenone | 236 (2.3) | 47 (2.4) | 154 (2.3) | 35 (2.3) | 0.9714 |
| Sotalol | 618 (6.1) | 90 (4.6) | 398 (6.0) | 130 (8.4) | <0.0001 |
| Other* | 131 (1.3) | 36 (1.8) | 77 (1.2) | 18 (1.2) | 0.0665 |
| Antithrombotic therapy (any use) | 9579 (94.9) | 1833 (93.1) | 6254 (95.0) | 1492 (96.6) | <0.0001 |
| Aspirin | 4452 (44.1) | 745 (37.8) | 2946 (44.7) | 761 (49.3) | <0.0001 |
| Clopidogrel | 712 (7.1) | 105 (5.3) | 494 (7.5) | 113 (7.3) | 0.0040 |
| Prasugrel | 14 (0.1) | 3 (0.2) | 9 (0.1) | 2 (0.1) | 0.9810 |
| Dabigatran | 496 (4.9) | 71 (3.6) | 352 (5.4) | 73 (4.7) | 0.0070 |
| Warfarin | 7198 (71.3) | 1381 (70.1) | 4705 (71.5) | 1112 (72.0) | 0.4116 |
| Combination antithrombotic therapy | |||||
| Aspirin and warfarin | 2556 (25.3) | 373 (18.9) | 1732 (26.3) | 451 (29.2) | <0.0001 |
| Aspirin and dabigatran | 155 (1.5) | 18 (0.9) | 108 (1.6) | 29 (1.9) | 0.0353 |
| Aspirin, clopidogrel, and warfarin | 165 (1.6) | 20 (1.0) | 122 (1.9) | 23 (1.5) | 0.0330 |
| Clopidogrel and warfarin | 334 (3.3) | 44 (2.2) | 230 (3.5) | 60 (3.9) | 0.0092 |
| Clopidogrel and dabigatran | 13 (0.1) | 3 (0.2) | 9 (0.1) | 1 (0.06) | 0.7371 |
| Aspirin, clopidogrel, and dabigatran | 3 (0.03) | 1 (0.05) | 1 (0.02) | 1 (0.06) | 0.4962 |
| Contraindications to anticoagulation | 1407 (13.9) | 295 (15.0) | 915 (13.9) | 197 (12.8) | 0.1667 |
| Management in anticoagulation clinic | 3112 (43.2) | 459 (33.2) | 2009 (42.7) | 644 (57.9) | <0.0001 |
AF indicates atrial fibrillation; AV, arterioventricular; CCB, calcium channel blocker.
*
Other includes disopyramide, ranolazine, quinidine, and other antiarrhythmic medications.