There are significant gaps between clinical trial results and real-world application of atrial fibrillation guidelines, highlighting the need for registries and active clinician involvement to improve adherence.
AF guideline gaps persist in practice; leaves open the impact of registries and clinician engagement on adherence.
SUMMARY The adherence to guidelines in atrial fibrillation (AF) management is not satisfactory. In particular, oral anticoagulant therapy is underused in AF patients and is not prescribed in accordance with thromboembolic risk. Moreover, the quality of oral anticoagulant therapy is suboptimal, with intensity often outside the target range (International Normalized Ratio: 2.0–3.0) and discontinuation after starting warfarin is substantial. Regarding therapeutic strategies, the choice between rhythm control and rate control is not driven by AF symptoms and the adherence to guidelines for AF substrate catheter ablation is moderate. AF patients are different from AF trial patients, in particular for age and comorbidities. Therefore, it is not surprising that relevant gaps exist between the results of research and their application in clinical practice. Database, registries, comparison among different medical centers and an active involvement of practicing clinicians may play a pivotal role for the assessment ...
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Pasquale et al. (2012) studied this question.
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