Atrial fibrillation: a primary care cross-sectional study.

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Atrial fibrillation (AF) is a prevalent arrhythmia in adults, significantly increasing mortality and morbidity risks.
• Understanding AF patient characteristics in primary care is crucial for effective management and public health strategies.

Purpose of the Study:

• To characterize patients diagnosed with atrial fibrillation (AF) in primary care settings in southern Israel.
• To analyze the prevalence, evaluation, and treatment patterns for AF, including antithrombotic and rate/rhythm control therapies.

Main Methods:

• A cross-sectional study was conducted across 14 primary care clinics in southern Israel.
• Electronic medical records of 995 adult patients diagnosed with AF were reviewed.
• Data analyzed included AF prevalence, patient demographics, antithrombotic treatment (Vitamin K antagonist - VKA), and rate/rhythm control treatments.

Main Results:

• The prevalence of AF was 1.5% (2.5% in those aged >= 45 years), with a mean patient age of 73.5 years; 55.3% were female.
• Vitamin K antagonist (VKA) was prescribed to 59% of patients, yet 8.5% lacked adequate international normalized ratio (INR) follow-up.
• Lower CHADS2 scores and non-VKA treatment were associated with significantly less rate-control therapy; anticoagulation correlated positively with rate or rhythm control.

Conclusions:

• The prevalence and age distribution of AF in southern Israel align with Western world findings.
• A significant proportion of AF patients did not receive appropriate antithrombotic prophylaxis, indicating a gap in care.
• Inadequate monitoring of VKA therapy and undertreatment of rate control in lower-risk patients were observed.