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Kardiyologlar için 2020 Avrupa Kardiyoloji Cemiyeti Atriyal Fibrilasyon Kılavuzunun Anket Çalışması

Year 2021, Volume: 12 Issue: 43, 83 - 87, 19.08.2021
https://doi.org/10.17944/mkutfd.919812

Abstract

Amaç: Atrial fibrilasyon (AF), en sık görülen klinik önemli kardiyak aritmidir. Klinik pratiğimizde, kardiyoloji alt uzmanlık dalları, akademik unvanları, kılavuzların ilk yayınlandığı günden itibaren okunma süreleri ile ilgili fark olup olmadığına yönelik bir çalışma yapmayı planlandık. Yöntem: Standart bir anket hazırladık ve Türkiye’de bütün kardiyologlara gönderdik. Ankette toplam 27 soru, dört soru AF tanısı, beş soru antikoagülasyon tedavi kararı skoru (CHADS2-VASc ve HAS-BLED), 12 soru AF antikoagülasyonu ile ilgili ve altı soru AF tedavisi ile ilgili olarak gruplanmıştır. İleride yayınlanacak kılavuzlara eklenmesi önerilen üç öznel soru da eklenmiştir.Bulgular: Bu çalışmada, 59 kardiyoloji uzmanı ankete katılmıştır. Ortanca yaş 36 (26-52) yıl olarak saptanmıştır ve 50 katılımcının erkek olduğu görülmüştür. Toplam, tanı, antikoagülasyon, tedavi ve antikoagülasyon skorunda başarılı kişi sayısı sırasıyla 25 (%42,4), 19 (%32,2), 30 (%50,8), 19 (%32,2) ve 45 (%76,3) olarak bulunmuştur. Katılımcılar akademik unvanlarına göre gruplanmıştır. Tanı, tedavi, antikoagülasyon ve antikoagülasyon skor soruları doğru cevap oranları, genel sorular hariç gruplar arasında benzer bulunmuştur. Profesörlerin tanı (68,75 puan), antikoagülasyon skoru (75 puan), genel (66,66 puan) soru gruplarında daha başarılı oldukları, doçentlerin ise antikoagülasyon (71,29 puan) ve tedavi (59,25 puan) soru gruplarında daha başarılı oldukları görülmüştür. Kardiyoloji alt uzmanlık dallarına göre ise toplam, antikoagülasyon ve tedavi soru gruplarında anlamlı fark mevcutken (p=0.005, p=0.012, p=0.037, sırasıyla) elektrofizyologlar ve klinik kardiyologlar arasında toplam soruların elektrofizyologlar lehine daha iyi yanıtlandığı (p=0.005) görülmüştür.Sonuç: Sonuç olarak, 2020 Avrupa Kardiyoloji Cemiyeti AF kılavuzlarının tüm kardiyoloji uzmanları tarafından iyi anlaşıldığı saptanmıştır. Fakat, kardiyolojide önemli bir hastalık olan AF için kılavuz anlaşılma oranlarının arttırılması önemlidir.

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References

  • Hart RG, Benavente O, McBride R, Pearce LA. Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Annals of internal medicine. 1999;131(7):492-501. https://doi.org/10.7326/0003-4819-131-7-199910050-00003
  • Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98(10):946-52. https://doi.org/10.1161/01.cir.98.10.946
  • Andrade JG, Verma A, Mitchell LB, Parkash R, Leblanc K, Atzema C, et al. 2018 focused update of the Canadian Cardiovascular Society guidelines for the management of atrial fibrillation. Canadian Journal of Cardiology. 2018;34(11):1371-92. https://doi.org/10.1016/j.cjca.2018.08.026
  • January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology. 2019;74(1):104-32. https://doi.org/10.1016/j.jacc.2019.01.011
  • Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomstro C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). European heart journal. 2020. 1;42(5):373-498. https://doi.org/10.1093/eurheartj/ehaa612
  • Packer DL, Mark DB, Robb RA, Monahan KH, Bahnson TD, Poole JE, et al. Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. Jama. 2019;321(13):1261-74. https://doi.org/10.1001/jama.2019.0693
  • Kuck KH, Merkely B, Zahn R, Arentz T, Seidl K, Schlüter M, et al. Catheter Ablation Versus Best Medical Therapy in Patients With Persistent Atrial Fibrillation and Congestive Heart Failure: The Randomized AMICA Trial. Circulation Arrhythmia and electrophysiology. 2019;12(12):e007731. https://doi.org/10.1161/CIRCEP.119.007731
  • Cosedis Nielsen J, Johannessen A, Raatikainen P, Hindricks G, Walfridsson H, Kongstad O, et al. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation. The New England journal of medicine. 2012;367(17):1587-95. https://doi.org/10.1056/NEJMoa1113566
  • Far M-T. The effects of text type, text length and text difficulty on vocabulary retention through glossing. The Journal of Language Learning and Teaching. 2016;6(1):90-104
  • Nowak H, Unterberg M. (Oral Anticoagulants: Management of Elective and Emergency Surgery). Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS. 2018;53(7-08):543-50. https://doi.org/10.1055/s-0043-111006
  • Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur Heart J. 2018;39(16):1330-93. https://doi.org/10.1093/eurheartj/ehy136
  • Marrouche NF, Brachmann J, Andresen D, Siebels J, Boersma L, Jordaens L, et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. The New England journal of medicine. 2018;378(5):417-27. https://doi.org/10.1056/NEJMoa1707855
  • Kong MH, Shaw LK, O’Connor C, Califf RM, Blazing MA, Al-Khatib SM. Is rhythm-control superior to rate-control in patients with atrial fibrillation and diastolic heart failure? Annals of noninvasive electrocardiology: the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. 2010;15(3):209-17. https://doi.org/10.1111/j.1542-474X.2010.00365.x

A Questionnaire of 2020 European Society of Cardiology Atrial Fibrillation Guideline for Cardiologists

Year 2021, Volume: 12 Issue: 43, 83 - 87, 19.08.2021
https://doi.org/10.17944/mkutfd.919812

Abstract

Objective: Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia. In our clinical practice, we wonder any knowledge differences between cardiology subspecialists, academic levels and first reading time interval for guidelines after published.
Methods:
A standard questionnaire was created and sent to all cardiology specialists through our country. 27 questions were grouped as total questions (27 questions), AF diagnosis criteria (4 questions), scores of anticoagulation treatment decision (5 questions) (CHADS2-VASc and HAS-BLED), anticoagulation for AF (12 questions) and AF treatment (6 questions). In addition, 3 subjective questions were asked about the issues that should be included in the next guidelines.
Results: 59 cardiology specialists participated in this survey. Median age was 36 (26-52) years and 50 physicians were male. According to total, diagnosis, anticoagulation, treatment and anticoagulation scores success, 25 (42.4%), 19 (32.2%), 30 (50.8%), 19 (32.2%) and 45 (76.3%) participants were successful, respectively. Participants were grouped as academic title. Diagnosis, treatment, anticoagulation and anticoagulation score questions’ collected points were not statistically significant different between groups. There was only a statistically significance according to total questions (p=0.04). Professors were more successful for diagnosis (68.75 points), anticoagulation score (75 points), total (66.66 points) and associate professors were more successful for anticoagulation (71.29 points) and treatment (59.25 points) questions. Cardiology subspecialties were compared according to questions’ groups. Total, anticoagulation and treatment questions were statistically significant different between groups (p=0.005, p=0.012, p=0.037, respectively). There was only statistically significance between electrophysiologists and clinic cardiologists according to total questions (p=0.005) in favor of electrophysiologists.
Conclusion: In conclusion, 2020 ESC AF guideline is well understood among all type of cardiology specialist. However, as AF is one the most important disease in cardiology, general understanding should be increased.

References

  • Hart RG, Benavente O, McBride R, Pearce LA. Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Annals of internal medicine. 1999;131(7):492-501. https://doi.org/10.7326/0003-4819-131-7-199910050-00003
  • Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98(10):946-52. https://doi.org/10.1161/01.cir.98.10.946
  • Andrade JG, Verma A, Mitchell LB, Parkash R, Leblanc K, Atzema C, et al. 2018 focused update of the Canadian Cardiovascular Society guidelines for the management of atrial fibrillation. Canadian Journal of Cardiology. 2018;34(11):1371-92. https://doi.org/10.1016/j.cjca.2018.08.026
  • January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology. 2019;74(1):104-32. https://doi.org/10.1016/j.jacc.2019.01.011
  • Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomstro C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). European heart journal. 2020. 1;42(5):373-498. https://doi.org/10.1093/eurheartj/ehaa612
  • Packer DL, Mark DB, Robb RA, Monahan KH, Bahnson TD, Poole JE, et al. Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. Jama. 2019;321(13):1261-74. https://doi.org/10.1001/jama.2019.0693
  • Kuck KH, Merkely B, Zahn R, Arentz T, Seidl K, Schlüter M, et al. Catheter Ablation Versus Best Medical Therapy in Patients With Persistent Atrial Fibrillation and Congestive Heart Failure: The Randomized AMICA Trial. Circulation Arrhythmia and electrophysiology. 2019;12(12):e007731. https://doi.org/10.1161/CIRCEP.119.007731
  • Cosedis Nielsen J, Johannessen A, Raatikainen P, Hindricks G, Walfridsson H, Kongstad O, et al. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation. The New England journal of medicine. 2012;367(17):1587-95. https://doi.org/10.1056/NEJMoa1113566
  • Far M-T. The effects of text type, text length and text difficulty on vocabulary retention through glossing. The Journal of Language Learning and Teaching. 2016;6(1):90-104
  • Nowak H, Unterberg M. (Oral Anticoagulants: Management of Elective and Emergency Surgery). Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS. 2018;53(7-08):543-50. https://doi.org/10.1055/s-0043-111006
  • Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur Heart J. 2018;39(16):1330-93. https://doi.org/10.1093/eurheartj/ehy136
  • Marrouche NF, Brachmann J, Andresen D, Siebels J, Boersma L, Jordaens L, et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. The New England journal of medicine. 2018;378(5):417-27. https://doi.org/10.1056/NEJMoa1707855
  • Kong MH, Shaw LK, O’Connor C, Califf RM, Blazing MA, Al-Khatib SM. Is rhythm-control superior to rate-control in patients with atrial fibrillation and diastolic heart failure? Annals of noninvasive electrocardiology: the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. 2010;15(3):209-17. https://doi.org/10.1111/j.1542-474X.2010.00365.x
There are 13 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Mehmet Özgeyik 0000-0002-8510-3505

Publication Date August 19, 2021
Submission Date April 18, 2021
Acceptance Date June 25, 2021
Published in Issue Year 2021 Volume: 12 Issue: 43

Cite

Vancouver Özgeyik M. A Questionnaire of 2020 European Society of Cardiology Atrial Fibrillation Guideline for Cardiologists. mkutfd. 2021;12(43):83-7.