Management of atrial fibrillation in the Greek healthcare setting.
BACKGROUND
Atrial fibrillation (AF) is the most frequent cardiac arrhythmia in the general population. AF management patterns have important implications for both the patient's quality of life and the utilisation of healthcare resources. This study aimed to investigate the management pattern of AF among cardiologists in the Greek healthcare setting.


METHODS
In order to construct the outpatient management model, the patient record data of 149 geographically distributed physicians were used. Data on inpatient resource utilisation were obtained from a consensus panel of AF experts.


RESULTS
89.6% of AF patients were treated with pharmacological agents, whereas 5.2% of patients were treated with invasive methods and 5.2% received no treatment. In 59.5% of patients under pharmacological therapy, a rhythm-control strategy was implemented, whereas for the remaining 40.5% of patients a rate-control strategy was selected. Class Ic and III antiarrhythmic agents constituted the main therapeutic choices in the rhythm-control strategy, whereas -blockers and digoxin were the most frequently prescribed agents in the rate-control strategy. 89.0% of the patients on pharmacological rhythm control, 91.3% of those on pharmacological rate control, and 100.0% of patients undergoing invasive treatment received antithrombotic medication.


CONCLUSIONS
Elimination of the rhythm disturbance and rhythm management are the dominant choices in AF management made by cardiologists in Greece. AF management requires close patient monitoring, as is reflected in the frequency of follow-up visits and laboratory tests performed, irrespective of treatment approach. Hospitalisations due to AF or related comorbidities are also common.
Department of Health Economics, National School of Public Health, Athens, Greece. ekarabli@esdy.edu.gr
Eleftheria
E
Karampli
Kostas
K
Athanasakis
Markos
M
Ollandezos
Elpida
E
Pavi
John
J
Kyriopoulos
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006115:Greece; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D005343:Fibrinolytic Agents