RESUMO
BACKGROUND: Current guidelines recommend a rhythm control strategy in patients with symptomatic atrial fibrillation (AF) while catheter ablation has been shown to be a safer and more efficacious approach than antiarrhythmic medications. METHODS: HECMOS was a nationwide snapshot survey of cardiorenal morbidity in hospitalized cardiology patients. In this sub-study, we included 276 cases who had a history of AF, particularly on the rhythm strategy, and catheter ablation procedures had been performed before the index admission. RESULTS: Among 276 AF patients (mean age: 76.4⯱â¯11.5â¯years, 58â¯% male), 60.9â¯% (Nâ¯=â¯168) had persistent AF and 39.1â¯% (Nâ¯=â¯108) had paroxysmal AF. Heart failure was the main cause of admission in 54.3â¯% (Nâ¯=â¯145) of the patients, while 14.1â¯% (Nâ¯=â¯39) were admitted due to paroxysmal AF, 7.3â¯% (Nâ¯=â¯20) due to bradyarrhythmic reasons, and 6.5â¯% (Nâ¯=â¯18) suffered from acute coronary syndrome. Most importantly, heart failure with reduced ejection fraction was present in 76 (27â¯%) patients. Only 10 patients out of the total (3â¯%, mean age 59.7â¯years) had undergone AF ablation while electrical cardioversion had been attempted in 37 (13.4â¯%) patients. Interestingly, in this AF population with heart failure, 3.6â¯% (Nâ¯=â¯10) had a defibrillator implanted (4 single-chamber), and only 1.5â¯% (Nâ¯=â¯4) had a cardiac resynchronization therapy defibrillator (CRT-D). CONCLUSION: High prevalence of persistent AF was detected in hospitalized patients, with heart failure being the leading cause of admission and main co-morbidity. Rhythm control strategies are notably underused, along with CRT-D implantation in patients with AF and heart failure.