[Temporal evolution of treatment of patients with atrial fibrillation in a urban health care area]

Abstract

Background and objective: To evaluate the adequacy of atrial fibrillation (AF) management 6 years after the establishment of a coordinated AF Unit.

Patients and methods: Patients with AF attended during 14 consecutive days in the Emergency Room, Internal Medicine, Neurology and Arrhythmia departments of a tertiary hospital, and 3 primary health care centers of the same urban health care area were included. Treatment for AF and its adequacy to current clinical guidelines, tests performed and knowledge about the arrhythmia were evaluated. Results were compared with a population of 239 patients treated 6 years earlier.

Results: One hundred and sixty-eight patients were included. Knowledge of the arrhythmia improved. The adequacy of treatment (rate control, rhythm control and antithrombotic prophylaxis) remained at the same level as in the previous period in all areas. The adequacy of thromboprophylaxis was negatively associated with advanced age (P < .001) and positively associated with knowledge of arrhythmia (P = .026).

Conclusion: Treatment of AF in a coordinated health area remains appropriate 6 years after the establishment of a coordinated AF unit. Elderly patients are still poorly anticoagulated. Health education may improve this deficit.

Keywords: Atrial fibrillation; Fibrilación auricular; Health care levels; Niveles asistenciales; Tratamiento; Treatment.