{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T19:02:28Z","timestamp":1768071748083,"version":"3.49.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,4,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Although guidelines for antiarrhythmic drug therapy in atrial fibrillation (\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              ) were published in 2006, it remains uncertain whether adherence to these guidelines affects patient outcomes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We retrospectively evaluated the records of 5976 consecutive\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              patients who were prescribed at least 1 antiarrhythmic drug between 2006 and 2013. Patients with 1 or more prescribed antiarrhythmic drugs that did not comply with guideline recommendations comprised the non\u2013guideline\u2010directed group (=2920); the remainder constituted the guideline\u2010directed group (=3056). Time to events was assessed using the survival analysis method and adjusted for covariates using Cox regression. Rates of adherence to the guidelines increased significantly with a higher degree of prescriber specialization in arrhythmias (49%, 55%, and 60% for primary care physicians, general cardiologists, and cardiac electrophysiologists, respectively,\n              <jats:italic>P<\/jats:italic>\n              =0.001) for the first prescribed antiarrhythmic drug. Compared to the non\u2013guideline\u2010directed group, the guideline\u2010directed group had higher rates of heart failure, but lower baseline\n              <jats:styled-content style=\"fixed-case\">CHADS<\/jats:styled-content>\n              2\u2010\n              <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>\n              c scores (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and lower rates of coronary artery disease, valvular disease, hypertension, hyperlipidemia, pulmonary disease, and renal insufficiency (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05 for all). During 45\u00b126\u00a0months follow\u2010up, the guideline\u2010directed group had a lower risk of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              recurrence (hazard ratio=0.86, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              =0.80 to 0.93), fewer hospital admissions for\u00a0\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              (hazard ratio=0.87, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              =0.79 to 0.97), and fewer procedures for recurrent\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              , including electrical cardioversion, pacemaker implantation, and atrioventricular nodal ablation (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01 for all). The mortality and stroke risks were similar between the groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Adherence to published guidelines in the antiarrhythmic management of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              is associated with improved patient outcomes.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.001793","type":"journal-article","created":{"date-parts":[[2015,4,7]],"date-time":"2015-04-07T01:43:05Z","timestamp":1428370985000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Patient Outcomes According to Adherence to Treatment Guidelines for Rhythm Control of Atrial Fibrillation"],"prefix":"10.1161","volume":"4","author":[{"given":"Dingxin","family":"Qin","sequence":"first","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Leef","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mian Bilal","family":"Alam","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Rattan","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad Bilal","family":"Munir","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divyang","family":"Patel","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Furqan","family":"Khattak","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishit","family":"Vaghasia","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Adelstein","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep K.","family":"Jain","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Saba","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2370"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1987.00370090041008"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000072767.89944.6E"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01236-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000441139.02102.80"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.958165"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.019927"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.08.037"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur192"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp235"},{"key":"e_1_3_2_12_2","first-page":"CD005049","article-title":"Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation","volume":"5","author":"Lafuente\u2010Lafuente C","year":"2012","unstructured":"Lafuente\u2010Lafuente C, Longas\u2010Tejero MA, Bergmann JF, Belmin J. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2012;5:CD005049.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq450"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.108.824789"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.177292"},{"key":"e_1_3_2_16_2","unstructured":"ICD\u20109\u2010CM Guidelines Conversion Table and Addenda. Classification of Diseases Functioning and Disability. National Center for Health Statistics CDC. Available at: http:\/\/www.cdc.gov\/nchs\/icd\/icd9cm.htm. Accessed December 15 2012."},{"key":"e_1_3_2_17_2","first-page":"449","volume-title":"Symposium on Cardiac Arrhythmias","author":"Vaughan Williams EM","year":"1970","unstructured":"Vaughan Williams EM. Classification of anti\u2010arrhythmic drugs. In: Sandfte E, Flensted\u2010Jensen E, Olesen KH, eds. Symposium on Cardiac Arrhythmias. Sodertalje, Sweden: AB ASTRA; 1970:449\u2013472"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.060061"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs253"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.022"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0803778"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199103213241201"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318214876d"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.115.001793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:52:58Z","timestamp":1715597578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.115.001793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,22]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,4,22]]}},"alternative-id":["10.1161\/JAHA.115.001793"],"URL":"https:\/\/doi.org\/10.1161\/jaha.115.001793","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,22]]},"assertion":[{"value":"2015-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-02-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-04-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e001793"}}