Journal of Arrhythmia (Aug 2019)

Regional collaboration to improve atrial fibrillation care: Preliminary data from the Netherlands heart network

  • Henricus‐Paul Cremers,
  • Cassandra Hoorn,
  • Luc Theunissen,
  • Pepijn van derVoort,
  • Peter Polak,
  • Sylvie deJong,
  • Dennis vanVeghel,
  • Lukas Dekker

DOI
https://doi.org/10.1002/joa3.12197
Journal volume & issue
Vol. 35, no. 4
pp. 604 – 611

Abstract

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Abstract Background Guideline non‐adherence and variations in therapeutic and diagnostic trajectories result in suboptimal atrial fibrillation (AF) treatments. Large academic and referral hospitals demonstrated positive effects of dedicated outpatient AF clinics. Although similar results have not been indicated in (small) non‐academic hospitals yet, ample opportunities are present when collaboration is initiated on a regional level. Therefore, this study assesses the effectiveness of outpatient AF clinics in a collaborative region in the Netherlands. Methods For this study baseline and 6 months follow‐up data of a prospective cohort including newly or recently diagnosed AF‐patients of 4 hospitals involved in the Netherlands Heart Network are used. From January’15 to March’16 patient relevant outcome measures (ie EHRA score, stroke, major bleedings, hospitalizations, serious adverse effects of medication, and mortality) are gathered. Descriptive and regression analyses are performed to assess the effectiveness of outpatient AF clinics. Results In the analyses 448 AF‐patients were included. After 6 months, significant improvements regarding EHRA score (P < 0.01), hypertension (P < 0.01), and type of AF (P < 0.01) were indicated. Results of the patient relevant outcomes showed that AF‐patients were hospitalized 23 times, no major bleedings and 2 strokes occurred. Furthermore, 0 AF‐patients reported serious adverse effects of medication and no AF‐patients deceased. Conclusions Collaboration between cardiologists in a regional setting permits further improvement of AF care. Therefore, such quality targets are not exclusively reserved to large academic or referral hospitals. Although promising, future research should put effort in measuring the effectiveness of the outpatient AF clinics also on the long run.

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