Show simple item record

Variation in practice patterns among specialties in the acute management of atrial fibrillation

dc.contributor.authorFunk, Ashley M
dc.contributor.authorKocher, Keith E
dc.contributor.authorRohde, Jeffrey M
dc.contributor.authorWest, Brady T
dc.contributor.authorCrawford, Thomas C
dc.contributor.authorFroehlich, James B
dc.contributor.authorSaberi, Sara
dc.date.accessioned2015-03-13T19:02:24Z
dc.date.available2015-03-13T19:02:24Z
dc.date.issued2015-03-12
dc.identifier.citationBMC Cardiovascular Disorders. 2015 Mar 12;15(1):21
dc.identifier.urihttps://hdl.handle.net/2027.42/110777en_US
dc.description.abstractAbstract Background Atrial fibrillation (AF) is commonly managed by a variety of specialists. Current guidelines differ in their recommendations leading to uncertainty regarding important clinical decisions. We sought to document practice pattern variation among cardiologists, emergency physicians (EP) and hospitalists at a single academic, tertiary-care center. Methods A survey was created containing seven clinical scenarios of patients presenting with AF. We analyzed respondent choices regarding rate vs rhythm control, thromboembolic treatment and hospitalization strategies. Finally, we contrasted our findings with a comparable Australasian survey to provide an international reference. Results There was a 78% response rate (124 of 158), 37% hospitalists, 31.5% cardiologists, and 31.5% EP. Most respondents chose rate over rhythm control (92.2%; 95% CI, 89.1% - 94.5%) and thromboembolic treatment (67.8%; 95% CI, 63.8% - 71.7%). Compared to both hospitalists and EPs, cardiologists were more likely to choose thromboembolic treatment for new and paroxysmal AF (adjusted OR 2.38; 95% CI, 1.05 - 5.41). They were less likely to favor hospital admission across all types of AF (adjusted OR 0.36; 95% CI, 0.17 - 0.79) but thought cardiology consultation was more important (adjusted OR 1.88, 95% CI, 0.97 - 3.64). Australasian physicians were more aggressive with rhythm control for paroxysmal AF with low CHADS2 score compared to US physicians. Conclusions Significant variation exists among specialties in the management of acute AF, likely reflecting a lack of high quality research to direct the provider. Future studies may help to standardize practice leading to decreased rates of hospitalization and overall cost.
dc.titleVariation in practice patterns among specialties in the acute management of atrial fibrillation
dc.typeArticleen_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/110777/1/12872_2015_Article_9.pdf
dc.identifier.doi10.1186/s12872-015-0009-1en_US
dc.language.rfc3066en
dc.rights.holderFunk et al.; licensee BioMed Central.
dc.date.updated2015-03-13T19:02:25Z
dc.owningcollnameInterdisciplinary and Peer-Reviewed


Files in this item

Show simple item record

Remediation of Harmful Language

The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.

Accessibility

If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.