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Quality indicators in the management of atrial fibrillation: the BALKAN-AF survey

Monika Kozieł1, Miroslav Mihajlovic2, Milan Nedeljkovic3

  • 1Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; 1st Department of Cardiology and Angiology, Silesian Centre for Heart Diseases, Zabrze, Poland.

International Journal of Cardiology
|February 23, 2021
PubMed

Insights

Quality indicators for atrial fibrillation (AF) care are crucial. This study found suboptimal oral anticoagulation (OAC) use for stroke prevention and low antiarrhythmic drug (AAD) use in AF patients, despite identifying many modifiable risk factors.

Area of Science:

  • Cardiology
  • Public Health
  • Health Services Research

Background:

  • Quality indicators are essential for improving atrial fibrillation (AF) management and patient outcomes.
  • Assessing adherence to quality indicators provides insights into current AF care practices.

Purpose of the Study:

  • To evaluate the concordance with established quality indicators for AF management within the BALKAN-AF cohort.
  • To identify areas for improvement in stroke prevention, rate/rhythm control, and risk factor management for AF patients.

Main Methods:

  • Post-hoc analysis of the BALKAN-AF dataset.
  • Assessment of patient data against quality indicators across domains: patient assessment, anticoagulation, rate control, rhythm control, and risk factor management.
  • Data collected at baseline visit.

Main Results:

  • Oral anticoagulation (OAC) prescription for stroke prevention was suboptimal, not consistently aligning with CHA2DS2-VASc scores.
  • Use of antiarrhythmic drugs (AADs) for rhythm control was low, particularly class IC AADs in patients with structural heart disease.
  • A high prevalence of modifiable risk factors (hypertension, obesity, alcohol abuse, smoking) was observed in the AF cohort.

Conclusions:

  • The BALKAN-AF cohort demonstrates suboptimal use of OAC for stroke risk and low AAD utilization.
  • There is a significant opportunity to improve AF management by addressing modifiable risk factors and optimizing guideline-adherent therapies.
  • Implementation of quality indicators is recommended to enhance AF care quality and patient outcomes.
Abstract

Keywords:
AnticoagulationAtrial fibrillationQuality indicatorsRate controlRhythm control

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