Atrial fibrillation (AF) is common, but there are limited data to guide selection of rate control medications (RCM). Reasons for selection are multivariable, and the impact on outcomes is unknown. We investigated prescribing patterns of RCM among patients with AF. Using a nationwide database, we identified 135,927 patients with AF. We stratified by baseline presence of heart failure with reduced ejection fraction (HFrEF) and examined prescription rates of RCM as a function of clinical variables. We also evaluated associations with clinical outcomes. Beta blockers (BB) were most commonly prescribed (44.6%), then calcium channel blockers (CCB) (14.0%) and digoxin (8.6%). Patients prescribed BB were more likely male (45.6% vs 43.4%, p < 0.0001), patients prescribed CCB were less likely male (12.0% vs 16.3%, p < 0.0001). There were higher rates of HF hospitalization (HFH) among females and those with Medicaid. Randomized trials are needed to define optimal choice of RCM.
Keyphrases
- atrial fibrillation
- heart failure
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- primary care
- prognostic factors
- left atrial
- oral anticoagulants
- catheter ablation
- metabolic syndrome
- direct oral anticoagulants
- left ventricular
- growth factor
- venous thromboembolism
- mass spectrometry
- adipose tissue
- electronic health record
- healthcare
- artificial intelligence
- mitral valve
- recombinant human
- data analysis