Quality indicators for the care and outcomes of adults with atrial fibrillation

Author:

Arbelo ElenaORCID,Aktaa Suleman1,Bollmann Andreas2,D’Avila André3,Drossart Inga4,Dwight Jeremy5,Hills Mellanie True6,Hindricks Gerhard2,Kusumoto Fred M7,Lane Deirdre A8,Lau Dennis H9,Lettino Maddalena10,Lip Gregory Y H8,Lobban Trudie11,Pak Hui-Nam12,Potpara Tatjana13,Saenz Luis C14,Van Gelder Isabelle C15,Varosy Paul16,Gale Chris P1,Dagres Nikolaos2,Boveda Serge17,Deneke Thomas18,Defaye Pascal19,Conte Giulio20,Lenarczyk Radoslaw21,Providencia Rui22,Guerra Jose M23,Takahashi Yoshihide24,Pisani Cristiano25,Nava Santiago26,Sarkozy Andrea27,Glotzer Taya V28,Martins Oliveira Mario29, , , ,

Affiliation:

1. Leeds Institute for Data Analytics, University of Leeds, UK; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, UK; Department of Cardiology, Leeds Teaching Hospitals NHS Trust, UK

2. Department of Electrophysiology, Heart Centre Leipzig at University of Leipzig, Leipzig, Germany

3. Cardiac Arrhythmia Service, Hospital SOS Cardio, Florianopolis, SC, Brazil; Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

4. European Society of Cardiology, Sophia Antipolis, France; ESC Patient Forum, Sophia Antipolis, France

5. ESC Patient Forum, Sophia Antipolis, France

6. StopAfib.org, American Foundation for Women’s Health, Decatur, TX, USA

7. Cardiology Department, Mayo Clinic Hospital, Jacksonville, FL, USA

8. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

9. Centre for Heart Rhythm Disorders, The University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

10. Cardiovascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy

11. Arrhythmia Alliance/AF Association/STARS, Chipping Norton, UK

12. Yonsei University Health System, Seoul, Republic of Korea

13. School of Medicine, University of Belgrade, Serbia; Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia

14. Fundación Cardio Infantil-Instituto de Cardiología, Bogotá, Colombia

15. Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands

16. Rocky Mountain Regional Veterans Affairs Medical Center and the University of Colorado Anschutz Medical Campus, Aurora, CO, USA

17. Clinique Pasteur, Heart Rhythm Department, 31076 Toulouse, France

18. Clinic for Interventional Electrophysiology, Heart Centre RHÖN-KLINIKUM Campus Bad Neustadt, Germany

19. CHU Grenoble Alpes, Unite de Rythmologie Service De Cardiologie, CS10135, 38043 Grenoble Cedex 09, France

20. Cardiology Department, Cardiocentro Ticino, Lugano, Switzerland

21. First Department of Cardiology and Angiology, Silesian Centre for Heart Disease, Curie-Sklodowskiej Str 9, 41-800 Zabrze, Poland

22. St Bartholomew’s Hospital, Barts Heart Centre, Barts Health NHS Trust, London, UK and Institute of Health Informatics, University College of London, London, UK

23. Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Universidad Autonoma de Barcelona, CIBERCV, Barcelona, Spain

24. Department of Advanced Arrhythmia Research, Tokyo Medical and Dental University, Tokyo, Japan

25. Heart Institute, Arrhythmia Unit, Sao Paulo, Brazil

26. Head of Electrocardiology Department, Instituto Nacional de Cardiologia ‘Ignacio Chavez’, Mexico

27. University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium

28. Hackensack Meridian-Seton Hall School of Medicine, Rutgers New Jersey Medical School; Director of Cardiac Research, Hackensack University Medical Center, Hackensack, USA

29. Hospital Santa Marta, Department of Cardiology, Rua Santa Marta, 1167-024 Lisbon, Portugal

Abstract

Abstract Aims To develop quality indicators (QIs) that may be used to evaluate the quality of care and outcomes for adults with atrial fibrillation (AF). Methods and results We followed the ESC methodology for QI development. This methodology involved (i) the identification of the domains of AF care for the diagnosis and management of AF (by a group of experts including members of the ESC Clinical Practice Guidelines Task Force for AF); (ii) the construction of candidate QIs (including a systematic review of the literature); and (iii) the selection of the final set of QIs (using a modified Delphi method). Six domains of care for the diagnosis and management of AF were identified: (i) Patient assessment (baseline and follow-up), (ii) Anticoagulation therapy, (iii) Rate control strategy, (iv) Rhythm control strategy, (v) Risk factor management, and (vi) Outcomes measures, including patient-reported outcome measures (PROMs). In total, 17 main and 17 secondary QIs, which covered all six domains of care for the diagnosis and management of AF, were selected. The outcome domain included measures on the consequences and treatment of AF, as well as PROMs. Conclusion This document defines six domains of AF care (patient assessment, anticoagulation, rate control, rhythm control, risk factor management, and outcomes), and provides 17 main and 17 secondary QIs for the diagnosis and management of AF. It is anticipated that implementation of these QIs will improve the quality of AF care.

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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