An international observational prospective survey assessing the control of atrial fibrillation in Asia-Pacific: results of the record-AFAP registry

A prospective 1-year observational survey was designed to assess the management and control of atrial fibrillation (AF) in eight countries within the Asia-Pacific region. Patients (N = 2,604) with recently diagnosed AF or a history of AF ≤1 year were included. Clinicians chose the treatment strategy (rhythm or rate control) according to their standard practice and medical discretion. The primary endpoint was therapeutic success. At baseline, rhythm- and rate-control strategies were applied to 35.7% and 64.3% of patients, respectively. At 12 months, therapeutic success was 43.2% overall. Being assigned to rhythm-control strategy at baseline was associated with a higher therapeutic success (46.5% vs 41.4%; P = 0.0214) and a lower incidence of clinical outcomes (10.4% vs 17.1% P < 0.0001). Patients assigned to rate-control strategies at baseline had higher cardiovascular morbidities (history of heart failure or valvular heart disease). Cardiovascular outcomes may be less dependent on the choice of treatment strategy than cardiovascular comorbidities.

The role of middle class in democratic diffusion

The modernization hypothesis and the democratic domino theory have been at the forefront in explaining the democratization around the globe. This paper empirically investigates the ‘middle class-driven modernization’ hypothesis and the ‘middle class-driven democratic domino’ effect in a panel of 145 countries over the period 1985 to 2013. Using several middle class measures and a dynamic panel estimator, we show that the ‘middle class-driven modernization’ hypothesis finds strong empirical support in the sample of developing countries excluding Eastern Europe and Central Asia, while the ‘middle class-driven democratic domino’ effect finds support in the sample of developing countries excluding East Asia and the Pacific