Integrated specialized atrial fibrillation clinics reduce all-cause mortality: post hoc analysis of a randomized clinical trial.

[vc_row full_width=”stretch_row” css=”.vc_custom_1548353430222{background-color: #8a1465 !important;}”][vc_column][vc_empty_space height=”10px”][/vc_column][/vc_row][vc_row full_width=”stretch_row”][vc_column][vc_empty_space height=”4px”][vc_custom_heading source=”post_title” font_container=”tag:h1|text_align:left|color:%23333333″ google_fonts=”font_family:Raleway%3A100%2C200%2C300%2Cregular%2C500%2C600%2C700%2C800%2C900|font_style:400%20regular%3A400%3Anormal”][/vc_column][/vc_row][vc_row][vc_column width=”2/3″][vc_column_text css=”.vc_custom_1585225770847{margin-top: 5px !important;margin-right: 5px !important;margin-bottom: 5px !important;margin-left: 5px !important;border-top-width: 2px !important;padding-top: 20px !important;padding-right: 20px !important;padding-bottom: 20px !important;padding-left: 20px !important;background-color: #ededed !important;}”]Research article published on Europace. . 2019 August 7

AUTHORS: Hendriks JML, Tieleman RG, Vrijhoef HJM, Wijtvliet P, Gallagher C, Prins MH, Sanders P, Crijns HJGM.


ABSTRACT

AIMS:
An integrated chronic care programme in terms of a specialized outpatient clinic for patients with atrial fibrillation (AF), has demonstrated improved clinical outcomes. The aim of this study is to assess all-cause mortality in patients in whom AF management was delivered through a specialized outpatient clinic offering an integrated chronic care programme.

METHODS AND RESULTS:
Post hoc analysis of a Prospective Randomized Open Blinded Endpoint Clinical trial to assess all-cause mortality in AF patients. The study included 712 patients with newly diagnosed AF, who were referred for AF management to the outpatient service of a University hospital. In the specialized outpatient clinic (AF-Clinic), comprehensive, multidisciplinary, and patient-centred AF care was provided, i.e. nurse-driven, physician supervised AF treatment guided by software based on the latest guidelines. The control group received usual care by a cardiologist in the regular outpatient setting.After a mean follow-up of 22 months, all-cause mortality amounted 3.7% (13 patients) in the AF-Clinic arm and 8.1% (29 patients) in usual care [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.23-0.85; P = 0.014]. This included cardiovascular mortality in 4 AF-Clinic patients (1.1%) and 14 patients (3.9%) in usual care (HR 0.28; 95% CI 0.09-0.85; P = 0.025). Further, 9 patients (2.5%) died in the AF-Clinic arm due to a non-cardiovascular reason and 15 patients (4.2%) in the usual care arm (HR 0.59; 95% CI 0.26-1.34; P = 0.206).

CONCLUSION:
An integrated specialized AF-Clinic reduces all-cause mortality compared with usual care. These findings provide compelling evidence that an integrated approach should be widely implemented in AF management.

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_column_text css=”.vc_custom_1585225792637{margin-top: 10px !important;}”]Keywords: Atrial fibrillation; Integrated care; Mortality; Multidisciplinary teams; Nurse co-ordination[/vc_column_text][vc_separator css=”.vc_custom_1555607586280{margin-top: -4px !important;}”][vc_btn title=”Full-text article (Pubmed)” style=”custom” custom_background=”#8eb223″ custom_text=”#ffffff” align=”center” i_icon_fontawesome=”fa fa-arrow-right” button_block=”true” add_icon=”true” link=”url:https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F31390464|title:Springer%20link|target:%20_blank|”][vc_separator][vc_posts_slider type=”flexslider_slide” count=”All” interval=”0″ slides_content=”teaser” slides_title=”1″ title=”See also:” posttypes=”post” categories=”publications” css=”.vc_custom_1555606478402{background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}”][/vc_column][vc_column][vc_empty_space][/vc_column][/vc_row][vc_row full_width=”stretch_row” css=”.vc_custom_1548353430222{background-color: #8a1465 !important;}”][vc_column][vc_empty_space height=”2px”][/vc_column][/vc_row]

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