Low Level of Knowledge of Atrial Fibrillation and Anticoagulant Treatment among Patients with Atrial Fibrillation Scheduled for Cardiac Surgery

Abstract

Objective: We investigated the knowledge about atrial fibrillation (AF) and oral anticoagulants (OACs) in AF patients scheduled for cardiac surgery compared with nonsurgical AF patients. Methods: We recruited 144 consecutive patients with documented AF scheduled for cardiac surgery on admission (aged 68.9±8.4, male 60.4 %). The control group represented 200 age- and sex-matched AF patients without indications for surgery. Using the validated Jessa AF Knowledge Questionnaire (JAKQ), we tested their knowledge of AF and the use of OAC. Results: The mean score on the JAKQ was 47±20 % in the surgery group and 59±18 % in the control group (p<0.001), without any questions in which the former group scored better. A higher level of knowledge was observed in patients taking vitamin K antagonists (VKA) in the past, and individuals free of heart failure, previous stroke, or peripheral artery disease. Patients had poor knowledge of the safety issues, including 27.5% of surgical patients who knew about possible painkillers use during anticoagulation compared with 43.8% in the control group (p=0.002). Patients scheduled for valvular surgery (n=88, 61.5%) scored better compared with those (n=26, 18.2%) for coronary artery bypass graft (CABG) surgery (49±19% vs. 35±18 %, p=0.002 respectively). Conclusion: The level of knowledge about AF and its treatment, including the safety issues, is poor among AF patients admitted for cardiac surgery. More educational efforts should be taken in this vulnerable patient subset.