Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases patients’ risk of stroke, heart failure and death, thereby contributing to an increased risk of CV morbidity and mortality.

In Canada, AF affects about 3% of people over the age of 45 and 6% of people over 65.1  There are approximately 250,000 Canadians currently living with AF and the incidence of AF is increasing as the population ages.

Symptoms of atrial fibrillation can have a negative impact on a patient’s physical, social and mental well being that can lead to significant morbidity, mortality and result in hospitalizations.

A recent study, Atrial Fibrillation Care: Challenges in clinical Practice and Educational Needs Assessment, published on February 15 in the Canadian Journal of Cardiology, confirms the seriousness of the condition, and shows perceived gaps and barriers impeding optimal care, uncertainty regarding  the pathophysiology of AF, and knowledge gaps across the care continuum, including screening, diagnosis and treatment.

Overview of study results – key findings:

• Lack of consensus as to whether AF is a disease in itself or a manifestation of something else.4
• Lack of knowledge, skills and confidence in identifying the underlying factors of AF.4
• Challenges when it comes to a distinction between AF and atrial flutter reported by FPs/GPs as well as by cardiologists, though to a lesser degree.4
• Physicians reported being challenged by the need to individualize and constantly adjust each treatment, lacking the knowledge, skills and confidence to support their clinical judgment.4
• Physicians also reported struggling with the treatment of asymptomatic patients, partly due to a lack of skills and confidence in communicating and explaining the risks of untreated AF with patients.4
• Suboptimal know ledge of CCS guidelines for management of patient with AF and lack of confidence in their application.

“The good news is that the results indicate that many FPs/GPs would be willing to expand their role if they had the necessary knowledge and skills.  This could reduce the number of referrals to cardiologists, ultimately reducing health care costs and waiting times for patients,” said Dr. Paul Dorian, Professor of Medicine and Pharmacology and Director, Division of Cardiology at the University of Toronto and one of the leading authors of the study.  “The Guidelines and the CCS dissemination strategy are very important but more will be needed  to improve practice and influence patient outcomes. Activities that will incorporate the Guidelines into day-to-day thinking and practice to help address those gaps will also be needed on an ongoing basis”