Current management of atrial fibrillation in routine practice according to the last ESC guidelines : an EHRA physician survey - how are we dealing with controversial approaches?
Guerra Ramos, José María (Institut de Recerca Sant Pau)
Moreno Weidmann, Zoraida (Institut de Recerca Sant Pau)
Perrotta, L. (Careggi University Hospital (Florència, Itàlia))
Sultan, A. (University of Cologne)
Anic, Ante (University Hospital Centre)
Metzner, Andreas (University Hospital Hamburg-Eppendorf)
Providência, Rui (University College London)
Boveda, S. (Brussels University VUB)
Chun, Julian K R (Agaplesion Markus Krankenhaus)
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	Aims: Although guidelines for the management of atrial fibrillation (AF) are regularly published, many controversial issues remain, limiting their implementation. We aim to describe current clinical practice among European Heart Rhythm Association (EHRA) community according to last guidelines. Methods and results: A 30 multiple-choice questionnaire covering the most controversial topics related to AF management was distributed through the EHRA Research Network, National Societies, and social media between January and February 2023. One hundred and eighty-one physicians responded the survey, 61% from university hospitals. Atrial fibrillation screening in high-risk patients is regularly performed by 57%. Only 42% has access to at least one programme aiming at diagnosing/managing comorbidities and lifestyle modifications, with marked heterogeneity between countries. Direct oral anticoagulants are the preferred antithrombotic (97%). Rhythm control is the preferred strategy in most AF phenotypes: symptomatic vs. asymptomatic paroxysmal AF (97% vs. 77%), low vs. high risk for recurrence persistent AF (90% vs. 72%), and permanent AF (20%). I-C drugs and amiodarone are preferred while dronedarone and sotalol barely used. Ablation is the first-line therapy for symptomatic paroxysmal AF (69%) and persistent AF with markers of atrial disease (57%) and is performed independently of symptoms by 15%. In persistent AF, 68% performs only pulmonary vein isolation and 32% also additional lesions. Conclusion: There is marked heterogeneity in AF management and limited accordance to last guidelines in the EHRA community. Most of the discrepancies are related to the main controversial issues, such as those related to AF screening, management of comorbidities, pharmacological treatment, and ablation strategy.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Ablation ; Antiarrhythmic treatment ; Anticoagulation ; Atrial fibrillation ; Comorbidities ; Clinical practice ; Guidelines
Publicado en:	Europace, Vol. 26 Núm. 2 (january 2024) , p. euae012, ISSN 1532-2092

DOI: 10.1093/europace/euae012
PMID: 38227804

9 p, 924.2 KB

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