Key result
Physician survey reveals highly variable AF pharmacological management where guideline indications are weak or absent.
Why the study?
Despite extensive literature and ESC guidelines, expert opinion remains divided on rate control, rhythm control, and thromboembolic prophylaxis in atrial fibrillation.
Cross-Sectional (n=106)
Yes
This national survey highlights significant heterogeneity in the real-world pharmacological management of atrial fibrillation among Italian cardiologists, emphasizing the need for further evidence in areas where guidelines are weak.
Underscores heterogeneity in AF pharmacotherapy where guidelines are weak; leaves open optimal strategies pending targeted trials.
AIM: Atrial fibrillation is a multifaceted disease requiring personalized treatment, in accordance with current ESC guidelines. Despite a wide range of literature, we still have various aspects dividing the opinion of the experts in rate control, rhythm control and thromboembolic prophylaxis. The aim of this survey was to provide a country-wide picture of current practice regarding atrial fibrillation pharmacological management according to a patient's characteristics. METHODS: Data were collected using an in-person survey that was administered to members of the Italian Association of Arrhythmology and Cardiac Pacing. RESULTS: We collected data from 106 physicians, working in 72 Italian hospitals from 15 of 21 regions. Our work evidenced a high inhomogeneity in atrial fibrillation management regarding rhythm control, rate control and thromboembolic prophylaxis in both acute and chronic patients. This element was more pronounced in settings in which literature shows a lack of evidence and, consequently, the indications provided by the guidelines are weak or absent. CONCLUSION: This National survey evidenced a high inhomogeneity in current approaches adopted for atrial fibrillation management by a sample of Italian cardiologist experts in arrhythmia management. Further studies are needed to explore if these divergences are associated with different long-term outcomes.
No takes yet. Share an insight, caveat, or question.
Diemberger et al. (2023) conducted a cross-sectional in Atrial fibrillation (n=106). Pharmacological management (survey of practice) was evaluated on Current practice regarding atrial fibrillation pharmacological management. A national survey of 106 Italian physicians revealed high inhomogeneity in the pharmacological management of atrial fibrillation, particularly where guideline indications are weak or absent.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: