open access

Vol 21, No 3 (2014)
Original articles
Published online: 2014-06-09
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Atrial fibrillation practice patterns among cardiac electrophysiologists and cardiologists

Tonye Teme, Jeffrey J. Goldberger
DOI: 10.5603/CJ.a2013.0089
·
Cardiol J 2014;21(3):293-298.

open access

Vol 21, No 3 (2014)
Original articles
Published online: 2014-06-09

Abstract

Background: Treatment paradigms for atrial fibrillation (AF) are highly variable. This study explores the management practices for AF between general cardiologists and electrophysiologists in an academic institution.

Methods: One hundred and eighty eight patients with AF who had primary outpatient evaluation by either a cardiologist (n = 94) or electrophysiologist (n = 94) in 2008 were selected from the Northwestern electronic medical record and included in the study. Chart review was used to determine the type of therapy, methods of monitoring AF, antiarrhythmic drug use patterns and outcome.

Results: Patients seen by cardiologists vs. electrophysiologists were older (70.3 ± 11.8 vs. 65.3 ± 10.3, p = 0.002) and had more diabetes (21.3% vs. 10.6%, p = 0.046), renal disease (29.0% vs. 9.2%, p = 0.001) and coronary artery disease (40.4% vs. 23.4%, p = 0.01). A rate control strategy was used more often (80.9% vs. 54.3%, p < 0.001), and antiarrhythmics were prescribed less (10.6% vs. 31.9%, p < 0.001) by cardiologists than electrophysiologists. Antiarrhythmic choices were amiodarone (33.3%), sotalol (20.0%), flecainide (13.3%), propafenone (13.3%), and dofetilide (23.3%) for electrophysiologists, and were limited to amiodarone (80%) and sotalol (20%) for cardiologists. After a mean follow-up of 14.0 ± 11.6 and 12.8 ± 11.1 months (p = 0.44) for patients managed by cardiologists and electrophysiologists, mortality was 13.8% and 6.4% (p = 0.09), respectively. Long-term ambulatory electrocardiogram monitoring was used more frequently by electrophysiologists (74.4%) than by cardiologists (55.6%, p = 0.15).

Conclusions: Practice patterns for treatment of AF significantly differ between electrophysiologists and cardiologists. Understanding specialist treatment patterns will help optimize individualized therapy for treatment of AF.

Abstract

Background: Treatment paradigms for atrial fibrillation (AF) are highly variable. This study explores the management practices for AF between general cardiologists and electrophysiologists in an academic institution.

Methods: One hundred and eighty eight patients with AF who had primary outpatient evaluation by either a cardiologist (n = 94) or electrophysiologist (n = 94) in 2008 were selected from the Northwestern electronic medical record and included in the study. Chart review was used to determine the type of therapy, methods of monitoring AF, antiarrhythmic drug use patterns and outcome.

Results: Patients seen by cardiologists vs. electrophysiologists were older (70.3 ± 11.8 vs. 65.3 ± 10.3, p = 0.002) and had more diabetes (21.3% vs. 10.6%, p = 0.046), renal disease (29.0% vs. 9.2%, p = 0.001) and coronary artery disease (40.4% vs. 23.4%, p = 0.01). A rate control strategy was used more often (80.9% vs. 54.3%, p < 0.001), and antiarrhythmics were prescribed less (10.6% vs. 31.9%, p < 0.001) by cardiologists than electrophysiologists. Antiarrhythmic choices were amiodarone (33.3%), sotalol (20.0%), flecainide (13.3%), propafenone (13.3%), and dofetilide (23.3%) for electrophysiologists, and were limited to amiodarone (80%) and sotalol (20%) for cardiologists. After a mean follow-up of 14.0 ± 11.6 and 12.8 ± 11.1 months (p = 0.44) for patients managed by cardiologists and electrophysiologists, mortality was 13.8% and 6.4% (p = 0.09), respectively. Long-term ambulatory electrocardiogram monitoring was used more frequently by electrophysiologists (74.4%) than by cardiologists (55.6%, p = 0.15).

Conclusions: Practice patterns for treatment of AF significantly differ between electrophysiologists and cardiologists. Understanding specialist treatment patterns will help optimize individualized therapy for treatment of AF.

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Keywords

practice patterns, management, atrial fibrillation

About this article
Title

Atrial fibrillation practice patterns among cardiac electrophysiologists and cardiologists

Journal

Cardiology Journal

Issue

Vol 21, No 3 (2014)

Pages

293-298

Published online

2014-06-09

DOI

10.5603/CJ.a2013.0089

Bibliographic record

Cardiol J 2014;21(3):293-298.

Keywords

practice patterns
management
atrial fibrillation

Authors

Tonye Teme
Jeffrey J. Goldberger

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