ATRIAL FIBRILLATION AT KUMLA HEALTHCENTRE – ANTICOAGULANT TREATMENTAND SYMPTOMS

Sammanfattning: Background: Atrial fibrillation (AF) is the most common sustained arrhythmia affecting anestimated 3 % of the adult population in the western world. The prevalence of the diseaseincreases with increasing age, thought to be due to structural changes in the heart as a result ofageing, long-term hypertension, or organic heart disease. The disorder increases the risk ofthromboembolism with the most common manifestation surfacing as a stroke. Oralanticoagulants such as novel oral anticoagulants or vitamin K antagonists are an essentialpreventative measure for strokes and are recommended by Socialstyrelsen and Europeancardiology guidelines. Patients with a high stroke risk not being treated according to theseguidelines constitute a high-risk group of individuals. Patients who are contraindicatedanticoagulants can undergo a left atrial appendage occlusion to reduce the risk of a stroke. Aim: To investigate anticoagulation treatment and symptoms of all patients aged 20 years andabove with the diagnosis AF at Kumla Health Centre in Örebro county between 2015 and 2018. Method: This care quality cohort study was based on all patients aged 20 years and abovewith the diagnosis AF at Kumla Health Centre. Data regarding their type of AF (paroxysmal,persistent or permanent), current medication, relevant comorbidities and risk factors for astroke according to CHA2DS2-VASc score were obtained from the Medrave 4 database. Thepatients’ diagnoses were verified using records of their electrocardiograms. Patients wereasked to fill out a validated symptom-questionnaire (AF-6) relating to their symptoms of AF.Data was collected and analysed using descriptive statistics. Results: 34 out of 456 (7.5 %) patients at Kumla Health Centre displayed a high stroke riskand were also missing relevant treatment according to current guidelines. When accountingfor contraindications for oral anticoagulation, there were 24 (5.3 %) eligible patients who didnot have satisfactory treatment. The prevalence of AF in Kumla was estimated to be 2.1 %,permanent AF was the most common subtype (63.4 %), followed by paroxysmal (31.8 %) andfinally persistent (4.8 %). 26 patients were offered a consultation with a cardiologist and 16out of 24 eligible (66.7 %) for anticoagulation agreed to an updated treatment plan. Conclusion: The vast majority of patients at Kumla Health Centre with an AF diagnosis werebeing treated according to current guidelines. The most common type of AF was permanent,and the least common was persistent. Most of the patients who were offered a consultationupdated their treatment plan.