Related Experiment Video
Updated: Sep 28, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Effects of the Atrial Fibrillation Better Care Pathway on Outcomes Among Clinically Complex Chinese Patients With
Agnieszka Kotalczyk1,2, Yutao Guo1,3, Maria Stefil1,4
1Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart & Chest Hospital Liverpool United Kingdom.
Insights
Adherence to the Atrial Fibrillation Better Care (ABC) pathway improved outcomes for complex Chinese patients with atrial fibrillation. This care pathway reduced adverse events and enhanced quality of life in those with multimorbidity or polypharmacy.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Atrial fibrillation patients often present with multimorbidity and polypharmacy, complicating care.
- The Atrial Fibrillation Better Care (ABC) pathway aims to provide integrated, holistic care.
- Assessing the ABC pathway's effectiveness in complex Chinese populations is crucial.
Purpose of the Study:
- To evaluate adherence to the ABC pathway in Chinese patients with atrial fibrillation.
- To determine the effectiveness of the ABC pathway in reducing adverse outcomes.
- To assess the impact of the ABC pathway on health-related quality of life.
Main Methods:
- Analysis of the prospective, multicenter ChiOTEAF registry (October 2014–December 2018).
- Inclusion of patients with atrial fibrillation, defined multimorbidity (≥2 comorbidities), and polypharmacy (≥5 medications).
- Primary outcomes: composite of all-cause death and thromboembolic events; individual end points; major bleeding.
Main Results:
- Adherence to the ABC pathway was linked to significantly lower risks of adverse outcomes in both multimorbidity (OR, 0.48) and polypharmacy (OR, 0.39) groups.
- Patients adhering to the ABC pathway reported better health-related quality of life compared to non-adherent patients.
- The study included substantial cohorts: 4644 with multimorbidity and 2262 with polypharmacy.
Conclusions:
- Adherence to the ABC pathway is associated with improved clinical outcomes in complex Chinese patients with atrial fibrillation.
- The ABC pathway positively impacts health-related quality of life in this patient population.
- Real-world data supports the ABC pathway's utility for managing atrial fibrillation in patients with multimorbidity and polypharmacy.
Abstract:
Background Patients with atrial fibrillation commonly have complex clinical backgrounds of multimorbidity and polypharmacy. The Atrial Fibrillation Better Care (ABC) pathway has been developed to help deliver integrated and holistic care for patients with atrial fibrillation. In this ancillary analysis, we assessed the adherence to and the effectiveness of the ABC pathway at reducing adverse outcomes in Chinese patients with atrial fibrillation with a complex clinical background of multimorbidity or polypharmacy. Methods and Results The ChiOTEAF (Optimal Thromboprophylaxis in Elderly Chinese Patients With Atrial Fibrillation) registry is a prospective, multicenter, nationwide study conducted from October 2014 to December 2018. The primary outcomes of interest were the composite end point of all-cause death and thromboembolic events, as well as individual end points of all-cause death, thromboembolic events, and major bleeding. Multimorbidity was defined as the presence of ≥2 comorbidities, and polypharmacy was defined as the concomitant use of ≥5 medications. The eligible cohort included 4644 patients with multimorbidity, of whom 2610 (56.2%) had available data to assess the ABC pathway usage (mean age, 74.4±10.2; 42.8% women). Among patients with polypharmacy (n=2262; mean age, 74.6±10.1; 43.3% women), 1328 (58.7%) had available data to assess the use of the ABC pathway. Adherence to the ABC pathway was associated with a lower risk of the primary composite outcome among patients with multimorbidity (odds ratio, 0.48; 95% CI, 0.29-0.79) and in the polypharmacy group (odds ratio, 0.39; 95% CI, 0.19-0.78). Health-related quality of life was lower in the non-ABC-adherent group compared with the ABC-treated patients. Conclusions This nationwide real-world registry shows that adherence to the ABC pathway is associated with improved clinical outcomes and health-related quality of life in clinically complex Chinese patients with atrial fibrillation with multimorbidity or polypharmacy.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:27Coronary Artery Disease V: Interprofessional Care
01:29Cardiomyopathy V: Interprofessional Care
01:27Peripheral Artery Disease III: Interprofessional Care
01:26Acute Coronary Syndrome V: Nursing Management
01:26Atherosclerosis III: Management