How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey.
This European Heart Rhythm (EHRA) Scientific Initiatives Committee EP Wire Survey aimed at exploring the common practices in approaching patients with atrial fibrillation (AF) and informing them about their risk profiles and available therapies in Europe. In the majority of 53 responding centres, patients were seen by cardiologists (86.8%) or arrhythmologists (64.2%). First- and follow-up visits most commonly lasted 21-30 and 11-20 min (41.5 and 69.8% of centres, respectively). In most centres (80.2%) stroke and bleeding risk had the highest priority for discussion with AF patients; 50.9% of centres had a structured patient education programme for stroke prevention. Individual patient stroke risk was assessed at every visit in 69.2% of the centres; 46.1% of centres had a hospital-based anticoagulation clinic. Information about non-vitamin K oral anticoagulants (NOACs) was communicated to all AF patients eligible for oral anticoagulation (38.5% of centres) or to warfarin-naive/unstable patients (42.3%). Only two centres (3.8%) had a structured NOAC adherence follow-up programme; in eight centres (15.4%) patients were requested to sign the statement they have been informed about the risks of non-adherence to NOAC therapy, and three centres (5.8%) had a patient education programme. Patient preferences were of the highest relevance regarding oral anticoagulation and AF ablation (64.7 and 49.0% of centres, respectively). This EP Wire Survey shows that in Europe considerable amount of time and resources are used in daily clinical practice to inform AF patients about their risk profile and available therapies. However, a diversity of strategies used across the European hospitals was noted, and further research is needed to better define optimal strategies for informing AF patients about their risk profile and treatment options.
Cardiology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Visegradska 26, Belgrade 11000, Serbia tatjana.potpara@mfub.bg.ac.rs tanjapotpara@gmail.com.
Tatjana S
TS
Potpara
Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Laurent
L
Pison
Department of Cardiology, Cardiovascular Research Centre, Aalborg University Hospital, Aalborg, Denmark.
Torben B
TB
Larsen
Deutsches Herzzentrum München and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Heidi
H
Estner
Cardiology Department, Ramón y Cajal Hospital, Madrid 28034, Spain.
Antonio
A
Madrid
Department of Cardiology, Institution of Medical Science, Uppsala University, Sweden.
Carina
C
Blomström-Lundqvist
D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D001294:Attitude to Health; D017115:Catheter Ablation; D003142:Communication; D005060:Europe; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D057240:Patient Preference; D010818:Practice Patterns, Physicians'; D012306:Risk; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires
D000925:Anticoagulants
Ablation; Anticoagulation; Atrial fibrillation; EHRA survey; EP wire; Education; Non-vitamin K oral anticoagulants; Patient preferences; Rate control; Rhythm control; Risk; Stroke