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Expert Consensus on Comprehensive Early Rhythm Control in Addition to Guideline-Based Care for Atrial Fibrillation : A Modified Delphi Survey

Deering, Thomas F. (författare)
Piedmont Heart Inst, Atlanta, GA 30309 USA.
Piccini, Jonathan P. (författare)
Duke Clin Res Inst, Durham, NC USA.
Graf, Marlon (författare)
PRECISIONheor, Bethesda, MD USA.
visa fler...
Chou, Jacquelyn W. (författare)
PRECISIONheor, Bethesda, MD USA.
Wilson, Rozanne (författare)
PRECISIONheor, Vancouver, BC, Canada.
Land, Natalie (författare)
PRECISIONheor, Bethesda, MD USA.
Mckindley, David S. (författare)
Sanofi, Bridgewater, NJ USA.
Singh, Charlotte M. (författare)
Sanofi, Bridgewater, NJ USA.
Blomström-Lundqvist, Carina (författare)
Uppsala universitet,Kardiologi-arrytmi,Örebro Univ, Fac Med & Hlth, Sch Med Sci, Dept Cardiol, Örebro, Sweden.
visa färre...
Piedmont Heart Inst, Atlanta, GA 30309 USA Duke Clin Res Inst, Durham, NC USA. (creator_code:org_t)
Elsevier, 2023
2023
Engelska.
Ingår i: American Journal of Cardiology. - : Elsevier. - 0002-9149 .- 1879-1913. ; 207, s. 328-335
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Atrial fibrillation (AF) practice guidelines recommend a rhythm-control strategy to improve symptoms and quality of life, noting the side effects of antiarrhythmic drugs and catheter ablation. Emerging evidence indicates that comprehensive early rhythm control with antiarrhythmic drugs or catheter ablation is associated with a lower risk of adverse cardiovascular outcomes versus the usual care. Using an online modified Delphi survey approach, perspectives and expert consensus among electrophysiologists were examined through a series of ranking and likelihood questions around treatment decision-making on (1) the use of comprehensive early rhythm-control strategies in patients with AF based on guidelines and emerging research and (2) treatment selection factors. A panel of 17 electrophysiologists reached a consensus on using early rhythm control (median 90, interquartile range 14) based on the view that early intervention improved cardiovascular outcomes (mean rank 1.6 of 3, 82% within 1 SD) and symptoms (1.8 of 3, 41%). AF-related symptoms were identified as the most important in making a treat-ment initiation decision (1.1 of 7, 88%), followed by AF type (2.5 of 7, 82%). Participants were most likely to initiate treatment at AF symptom onset (median 80; interquartile range 6). In making treatment selection decisions, participants ranked short-term/long-term safety (1.9 of 7, 88%) and efficacy (1.8 of 7, 53%) as the top 2 considerations. In conclusion, experts were in favor of early rhythm control; however, additional research is needed to address the role that early rhythm-control strategies play in current AF treatment management algorithms.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

atrial fibrillation
early rhythm control
treatment management
Delphi method

Publikations- och innehållstyp

ref (ämneskategori)
art (ämneskategori)

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