Does an interdisciplinary outpatient atrial fibrillation (AF) clinic affect the number of acute AF admissions? A retrospective cohort study

Abstract

To investigate the impact of a multidisciplinary outpatient clinic for patients with atrial fibrillation-clinic on the number of acute hospitalisations for atrial fibrillation compared with usual outpatient care for this condition before the establishment of the atrial fibrillation-clinic. Guidelines recommend a structured outpatient clinic follow-up in multidisciplinary teams for patients with atrial fibrillation due to fewer hospitalisations and death. However, the evidence base is weak. The study is a retrospective cohort study including a total of 129 patients from the cardiac outpatient clinic at a large Danish University Hospital. The study population consisted of two groups: a usual care group before a dedicated atrial fibrillation-clinic was established (n=73) and the atrial fibrillation-clinic group (n=56). The primary endpoint was acute hospitalisation for atrial fibrillation. Cox regression was used to assess the hazard ratio for acute hospitalisations for atrial fibrillation. When comparing the atrial fibrillation-clinic with the usual care group, adjusted for age and sex, this study showed a trend towards more frequent acute hospitalisations in the usual care group. The results of this study are hypothesis-generating and should lead to larger prospective trials to evaluate the impact of dedicated multidisciplinary atrial fibrillation-clinics on atrial fibrillation-related issues as acute hospitalisations for atrial fibrillation, symptoms and quality of life. Follow-up in a dedicated multidisciplinary AF-clinic might empower patients better to cope with acute arrhythmia symptoms.