The median age of the cohort at recruitment was 65?years (IQR 56C74). and 42.2% patients, respectively. Chronic kidney disease was observed in 46.6%, coronary artery disease in 34.8% and heart failure (HF) in 26.5% of patients. Mean CHA2DS2-VASc score Glimepiride of the cohort was 2.9, and HAS-BLED score was 1.7. Detailed information of antithrombotic and antiarrhythmic drugs was collected at baseline and on follow-up. During 1-12 months follow-up, 443 deaths (12.9%) occurred of which 332 (9.7%) were cardiac death and 63 (1.8%) were due to stroke. There were 578 (16.8%) hospitalisations mainly due to acute coronary syndrome, arrythmias and HF. Future plans Currently, this is the largest prospective study on AF patients from India, and the cohort will be followed for 5?years to observe the treatment patterns and clinical outcomes. The investigators encourage collaborations with national and international AF researchers. Trial registration number CTRI/2017/10/010097. strong class=”kwd-title” Keywords: atrial fibrillation, cardiac arrhythmia, disease registry, prospective study, stroke Strengths and limitations of this study Currently the largest prospective cohort of atrial fibrillation (AF) patients from South Asia. Fifty-three participating centres recruited patients from government hospitals, teaching institutions, private and corporate hospitals located both in urban and rural areas of Glimepiride Kerala state. The collected data included physical examination, electrocardiographic and echocardiographic findings, laboratory investigations of blood sample and follow-up outcomes. Although the study is limited to Kerala, results may provide an indication of future epidemiology of AF in India as Kerala is usually ahead of other says in epidemiological transition. However, these registry data may not reflect the true incidence or prevalence of AF in the state, since it is usually a hospital-based study. Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia seen in clinical practice, and it is an independent risk factor for death in men and women.1 AF is associated with a fivefold increase in stroke risk and 25%C30% stroke seen in adults are associated with this arrhythmia.2 3 While AF is a global problem, much of the available epidemiological data are from the Western countries and the Far East.4 Limited published data exist Glimepiride around the clinical epidemiology of AF in South Asia (see?online?supplementary table 1). Supplementary databmjopen-2018-025901supp001.pdf Kerala, the southernmost state of India, is witnessing an increase in the burden of patients with AF due to increased longevity, higher prevalence of cardiovascular risk factors and comorbid conditions.5 6 However, the treatment and care offered to these patients is generally perceived to be suboptimal especially with regard to stroke prevention strategy. Vitamin K antagonists (eg, warfarin) are the commonly used oral anticoagulants, but monitoring of international normalised ratio (INR) is usually highly erratic,7 and often low target values (Internatioal normalized ratio (INR)? 2.0) is accepted by the physicians. Nevertheless, there is lack of information on the existing treatment strategy as well as how it compares with the guideline recommended management of AF.8 The Kerala AF registry aims to provide systematic, prospective data on clinical characteristics, risk factors, treatment pattern and outcomes of consecutive AF patients who consulted cardiologists across Kerala. The registry was instituted under the auspices of Cardiological Society of India, Kerala Chapter (CSI-K). Cohort description All newly and previously diagnosed patients aged?18 years with documented evidence of AF on ECG were included in the study from April 2016 to April 2017. The study was initiated in April 2016, and 53 hospitals across the state of Kerala have contributed patients during the 1?year enrolment period. In order to get the best representative data from both rural and urban areas of the whole state, patients were recruited.Even though the multinational cross-sectional study, the Real-Life Global Survey Evaluating Patients with Atrial Fibrillation16 17 had an Indian cohort of 301 patients, all were recruited from private healthcare institutions located in 15 urban areas. days were excluded. Findings to date A total of 3421 patients were recruited from 53 hospitals across Kerala from April 2016 to April 2017. There were 51% (n=1744) women. The median age of the cohort was 65 (IQR 56C74) years. Hypertension, diabetes mellitus and dyslipidaemia were present in 53.8%, 34.5% and 42.2% patients, respectively. Chronic kidney disease was observed in 46.6%, coronary artery disease in 34.8% and heart failure (HF) in 26.5% of patients. Mean CHA2DS2-VASc score of the cohort was 2.9, and HAS-BLED score was 1.7. Detailed information of antithrombotic and antiarrhythmic drugs was collected at baseline and on follow-up. During 1-12 months follow-up, 443 deaths (12.9%) occurred of which 332 (9.7%) were cardiac death and 63 (1.8%) were due to stroke. There were 578 (16.8%) hospitalisations mainly due to acute coronary syndrome, arrythmias and HF. Future plans Currently, this is the largest prospective study on AF patients from India, and the cohort will be followed for 5?years to observe the treatment patterns and clinical outcomes. The investigators encourage collaborations with national and international AF researchers. Trial registration number CTRI/2017/10/010097. strong class=”kwd-title” Keywords: atrial fibrillation, cardiac arrhythmia, disease registry, prospective study, stroke Strengths and limitations of this study Currently the largest prospective cohort of atrial fibrillation (AF) patients from South Asia. Fifty-three participating centres recruited patients from government hospitals, teaching institutions, private and corporate hospitals located both in urban and rural areas of Kerala state. The collected data included physical examination, electrocardiographic and echocardiographic findings, laboratory investigations of blood sample and follow-up outcomes. Although the study is limited to Kerala, results may provide an indication of future epidemiology of AF in India as Kerala is usually ahead of other says in epidemiological transition. However, these registry data may not reflect the true incidence or prevalence of AF in the state, since it is usually a hospital-based study. Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia seen in clinical practice, and it is an independent risk factor for death in men and women.1 AF is associated with a fivefold increase in stroke risk and 25%C30% stroke seen in adults are associated with this arrhythmia.2 3 While AF is a global problem, Glimepiride much of the available epidemiological data are from the Western countries and the Far East.4 Limited published data exist around the clinical epidemiology of AF in South Asia (see?online?supplementary table 1). Supplementary databmjopen-2018-025901supp001.pdf Kerala, the southernmost state of India, is witnessing an increase in Glimepiride the burden of patients with AF due to increased longevity, higher prevalence of cardiovascular risk factors and comorbid conditions.5 6 However, the treatment and care offered to these patients is generally perceived to be suboptimal especially with regard to stroke prevention strategy. Vitamin K antagonists (eg, warfarin) are the commonly used oral anticoagulants, but monitoring of international normalised ratio (INR) is usually highly erratic,7 and often low target values (Internatioal normalized ratio (INR)? 2.0) is accepted by the physicians. Nevertheless, there is lack of information on the existing treatment strategy as well as how it compares with the guideline recommended administration of AF.8 The Kerala AF registry aims to supply systematic, prospective data on clinical features, risk elements, treatment design and outcomes of consecutive AF individuals who consulted cardiologists across Kerala. The registry was instituted beneath the auspices of Cardiological Culture of India, Kerala Section (CSI-K). Cohort explanation All recently and previously diagnosed individuals aged?18 years with documented proof AF on ECG were contained in the study from April 2016 to April 2017. The analysis was initiated in Apr 2016, and 53 private hospitals across the condition of Kerala possess contributed patients through the 1?season enrolment period. To be able to get the very best consultant data from both rural and cities of the complete condition, patients had been recruited from authorities, corporate and business and hostipal wards from different parts of Kerala. At each site, 1 investigator and a scholarly research planner handled the individual recruitment. Kerala condition comes with an particular part of 38?863?kilometres2 and a inhabitants of NCR3 37.3?million.9 For better coordination from the scholarly research, Kerala was divided into three zones: south, middle and north with 20 south participating sites from, 21 from middle.