GENEVA--(Marketwire - April 30, 2010) - Although serious and the most common of heart rhythm disorders, atrial fibrillation (AF) patients are unaware of the risks, complexities and consequences of AF and many doctors find its management to be a clinical and health-economic burden, according to survey results published today in the online edition of EP Europace.
Results taken from an international survey of more than 1,600 cardiologists and AF patients in 11 countries, found that only 43 percent of physicians and 55 percent of patients consider AF to be life-threatening(1). Yet, AF carries a fivefold increase in the risk of stroke(2) and the risk of death is double that of patients without AF(3). During the past 20 years, hospital admissions for AF have increased by 66 percent(3).
The survey of cardiologists and patients was conducted on behalf of AF AWARE (Atrial Fibrillation AWareness And Risk Education). AF AWARE is a joint initiative of four leading patient and medical associations -- World Heart Federation, Atrial Fibrillation Association, Stroke Alliance For Europe and European Heart Rhythm Association -- to highlight and address issues that contribute to the growing burden of atrial fibrillation worldwide.
"As a modifiable risk factor for serious cardiovascular consequences and death, the survey results paint a disturbing picture where the level of understanding about AF -- even among cardiologists -- is insufficient for patients to fully appreciate the seriousness and risks," said Prof. Günter Breithardt, co-author of the paper who also represents World Heart Federation for AF AWARE. "More and better education about AF, its consequences and management is urgently needed for doctors, patients and the public."
More than half of the patients surveyed had their AF recognized during a routine check-up or during a visit for another condition(1), indicating a lack of urgency to seek medical attention for symptoms. This is significant because the longer a patient's heart is out of rhythm, the harder it is to get back in rhythm.
"Individuals who experience symptoms such as a flopping or pounding sensation in their chest should be screened for AF by a physician," noted Prof. Breithardt. "Since it is a condition that worsens over time, early identification and treatment of AF could help reduce the risk of serious cardiovascular complications associated with this disease and potentially improve long-term health outcomes such as keeping patients out of the hospital."
Further evidence that patients lack a good understanding of AF and its management is that nearly 90 percent of patients surveyed reported being treated for AF, yet more than 80 percent reported ongoing symptoms. More than one-quarter said they experienced symptoms at least weekly. Oddly, patients voiced high levels of satisfaction with treatment. Additionally despite the nature and risks of AF, at least one in four patients surveyed said he or she did not understand and could not explain what AF is(1).
The survey also suggests that physicians consider AF difficult and time-consuming to manage, placing increased strain on healthcare systems. Patients reported an average of nine doctor visits per year for AF. Cardiologists rated AF as the third most demanding condition (after heart attack and heart failure) and the second most difficult condition (after heart attack) to manage in practice. Further, more than one in four physicians felt that AF was either too complicated to explain to patients or that they did not have enough time to fully explain AF to patients(1).
Previous research has shown that AF represents one-third of hospitalisations for arrhythmia and that 70 percent of the annual cost of AF management in Europe is driven by hospitalisation care and interventional procedures(3,4). Advances in treatment now offer the possibility of reducing complications such as cardiovascular hospitalization, potentially lowering the high costs associated with AF.
Atrial fibrillation
Atrial fibrillation is the most common cardiac arrhythmia (abnormal heart rhythm) seen by doctors. It is a fast growing public health concern currently affecting an estimated seven million people in the USA and Europe alone, and it is expected to double by 2050, reflecting the growing proportion of elderly individuals(3,5). AF results from abnormal electrical activity in the upper chambers of the heart (atria), leading to an irregular heart rhythm which prevents the blood from efficiently being pumped toward the rest of the body. Common symptoms of AF include palpitations (a rapid, irregular, "flopping" movement or pounding sensation in the chest), shortness of breath, dizziness and feeling of heaviness in the chest.
Age, obesity, hypertension, myocardial infarction (MI), congestive heart failure (CHF) and valvular heart diseases put patients at increased risk of developing AF, and AF itself worsens the prognosis of patients with cardiovascular risk factors. It is also an independent risk factor for stroke.
For further information and local country data, please contact
Charanjit Jagait, Director of Communications, World Heart Federation
+41 22 807 03 34; charanjit.jagait@worldheart.org
AF AWARE
AF AWARE's goals support broader initiatives for cardiovascular disease prevention such as the recently-formed European Parliament's MEP Heart Group which brings together the European Heart Network and European Society of Cardiology.
AF AWARE is supported by an unrestricted educational grant from sanofi-aventis.
World Heart Federation
The World Heart Federation is dedicated to leading the global fight against heart disease and stroke with a focus on low and middle income countries via a united community of more than 200 member organizations. With its members, the World Heart Federation works to build global commitment to addressing cardiovascular health at the policy level, generate and exchange ideas, share best practice, advance scientific knowledge and promote knowledge transfer to tackle cardiovascular disease -- the world's number one killer. It is a growing membership organization that brings together the strength of medical societies and heart foundations from more than 100 countries. Through our collective efforts we can help people all over the world to lead longer and better heart-healthy lives.
AF AWARE Survey
The AF AWARE survey objective was to explore the differences and gaps in cardiologists' and patients' perceptions of atrial fibrillation (AF) by analysing perceptions of AF risks, patients' level of information, impact of AF and its consequences on patients quality of life (QoL). The survey consisted of 810 cardiologists and 825 patients from 11 countries. Cardiologists arm: 96% of interviews were conducted online and the remainder by phone involving 24 questions (most using a 5-point scale). Patients arm: 43% of interviews were conducted online, 40% by phone and 17% face to face. Questionnaires to cardiologists explored their evaluation of risks associated with AF and its treatment, the type of communication/information given to patients, perceived levels of patient familiarity with AF, frequency/nature of consultations and level of patient satisfaction, QoL and health-economic impact of AF. The patient survey asked patients for an estimate/rate of risk of AF relative to other diseases, to describe their understanding of AF, define preferred sources of/satisfaction with AF information, describe the impact of AF on daily living.
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References:
- Aliot E, Breithardt G, Brugada J, et al. An international survey of physicians and patient understanding, perception and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortality. EP Europace. Epub 2010 Apr.
- Lloyd-Jones et al. Circulation 2004; 110:1042-1046
- Fuster V et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation. European Heart Journal 2006;27:1979-2030.
- Ringborg A, et al. Costs of atrial fibrillation in five European countries: results from the Euro Heart Survey on atrial fibrillation. Europace. 2008 Apr;10(4):403-11. Epub 2008 Mar
- Go AS et al. JAMA 2001; 285: 2370-2375.
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