Review Article

Epidemiology and Management of Atrial Fibrillation and Stroke: Review of Data from Four European Countries

Table 3

Management considerations.

Management considerationsUKFranceNetherlandsRomania

Organisation of treatment100% GP following the national guidelines (NICE 2014)2/3 GP, 1/3 cardiologist (Touze 2005) access to biology laboratories is quite easy (Le Heuzey et al. 2014)GP/cardiologist set the diagnose (Willemsen 2011) (Camm 2010), anticoagulation clinics responsible for monitoring and dosing (Rosendaal 1996)GP, medical specialist, cardiologist (Purcarea 2009)

MedicationVKA used in 75% of the cases of treatment with OAC (Le Heuzey et al. 2014)VKA used in 86% of the cases of treatment with OAC (Le Heuzey et al. 2014)NANOAC or VKA 28,5%
Aspirin 46% (Zdrenghea 2009)

Available guidelinesESC 2010, NICE clinical guideline 2006, 2014ESC 2010, PPSPR 2011, HAS Guide Parcours de Soins-Fibrillation atriale 2014ESC 2010, NHG, CBOESC 2006 (2010)

Undertreatment34% of AF patients with CHADsVASc >2 do not receive OAC treatment (Barra 2015; Shantsila 2015; De Wilde 2006)More than 50% of stroke patients with AF do not receive OAC treatment (Touzé 2005, Kirchhof 2012)Undertreatment with OAC drugs in the elderly (Willemsen 2011, Arts 2013)Almost all categories of drugs are underused (Zdrenghea 2009; Lip 2015)

Detection rateScreening programs for +65 through the GP (Fitzmaurice 2005)Not much done (Touzé 2005)Done aleatory, when patients present themselves with symptoms to the GP (Heemstra 2011)Preventive measurements still lacking

Each of the items per row represents the value for the country followed by the reference between brackets.