| Differences in management of atrial fibrillation between cardiologists and non-cardiologists in Greece. | |
| | |
MedLine Citation:
|
PMID: 20378512 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: We aimed to assess trends in the management of atrial fibrillation (AF) at various levels of medical care in Greece and to compare the treatment practices of cardiologists to those of non-cardiologists. METHODS: From January to May 2007, 500 questionnaires were mailed to cardiologists, internists and general practitioners, randomly selected from regional medical associations. Questions assessed management practices for paroxysmal, persistent and permanent AF. RESULTS: A total of 309 physicians (194 cardiologists and 115 non-cardiologists) responded. Cardiologists showed no preference regarding the site of cardioversion of paroxysmal AF, whereas non-cardiologists tend to cardiovert paroxysmal AF in the emergency department. Intravenous amiodarone is the most frequently used antiarrhythmic agent for cardioversion by both groups (63% vs. 71%, p=NS). Cardiologists utilise propafenone or ibutilide more frequently than non-cardiologists (24% vs. 11%, p<0.05 and 10% vs. 2%, p<0.01 respectively), while 12% of non-cardiologists would use digitalis for cardioversion (vs. 0.5% of cardiologists, p<0.001). Cardiologists prescribe commonly, but less frequently than non-cardiologists (42% vs. 59%, p<0.01) an antiarrhythmic drug after the first episode of paroxysmal AF, propafenone being the most popular among cardiologists (66%) and amiodarone (33%) or digitalis (23%) among general practitioners/internists. Beta-blockers are considered as first choice agents for rate control among cardiologists, while non-cardiologists would prescribe mainly digitalis. Antiplatelet agents were suggested by most physicians after cardioversion of the first episode of AF in low-risk patients. Cardiologists prefer aspirin, while non-cardiologists would prescribe clopidogrel as first choice antiplatelet agent. Both groups would recommend anticoagulants in high risk patients; nevertheless, in elderly patients without other risk factors, anticoagulants are more often prescribed by cardiologists (79% vs. 50%, p<0.001). CONCLUSIONS: Important differences exist in the management of AF between cardiologists and general practitioners/internists in Greece. Non-cardiologists overuse digitalis, underuse beta-blockers, prefer clopidogrel to aspirin and are reluctant to prescribe anticoagulants in the elderly. |
| | |
Authors:
|
Vassilios P Vassilikos; Aggeliki Mantziari; Christos A Goudis; Stelios Paraskevaidis; Georgios Dakos; Georgios Giannakoulas; Georgios Giannoglou; Sotirios Mochlas; Ioannis H Styliadis; Georgios Parcharidis |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē Volume: 51 ISSN: 1109-9666 ISO Abbreviation: Hellenic J Cardiol Publication Date: 2010 Mar-Apr |
Date Detail:
|
Created Date: 2010-04-09 Completed Date: 2010-12-14 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101257381 Medline TA: Hellenic J Cardiol Country: Greece |
Other Details:
|
Languages: eng Pagination: 113-21 Citation Subset: IM |
Affiliation:
|
First Cardiology Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anti-Arrhythmia Agents
/
therapeutic use* Atrial Fibrillation / therapy*, ultrasonography Cardiology* Electric Countershock / methods* Electrocardiography / methods Exercise Test / utilization Family Practice Greece Humans Internal Medicine Length of Stay |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Arrhythmia Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Percutaneous closure of atrial septal defects: immediate and mid-term results.
Next Document: Cryoablation versus radiofrequency ablation for atrioventricular nodal reentrant tachycardia in chil...