The European Society of Cardiology quality indicators in atrial fibrillation in centers of excellence in Spain: the SEC-EXCELENTE FA registry.

Autores de IIS La Fe

• Francisco Marin Ortuño

  Autor

• Joaquín Osca Asensi

  Autor

Participantes ajenos a IIS La Fe

• Arbelo, Elena
• Roldan Rabadan, Inmaculada
• Perez Cabeza, Alejandro
• Marzoa Rivas, Raquel
• Del Rio Lechuga, Ana
• Elola Somoza, Francisco Javier
• Anguita Sanchez, Manuel
• Ruiz Ortiz, Martin
• Peinado Peinado, Rafael
• Arbelo Lainez, Elena
• Valle Alberca, Almudena
• Ibanez Criado, Alicia
• Valle Munoz, Alfonso
• Rio Lechuga, Ana Del
• Perez Cabeza, Alejandro I
• investigators of the SEC- EXCELENTE FA registry

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

Abstract

INTRODUCTION AND OBJECTIVES: By 2022, 9 centers had been accredited by the Spanish Society of Cardiology for the atrial fibrillation (AF) process. Our objective was to evaluate the performance of these centers based on the quality indicators (QIs) proposed by the European Society of Cardiology (ESC) in 2020. METHODS: Adults with AF who were attended in the cardiology departments of participating centers during the second week of May 2019 were included in a retrospective registry (n=797, age 72±11 years, 60% male). Key ESC QIs were assessed. RESULTS: CHA2DS2-VASc, HAS-BLED scores, and serum creatinine levels were documented in 24.9%, 6.1%, and 96.2% of patients, respectively. Anticoagulation was appropriately prescribed in 90.6% of high-risk patients according to the CHA2DS2-VASc score, but was inappropriately prescribed in 57.8% of low-risk patients. Among all patients, 84.1% received high-quality anticoagulation. Inappropriate antiarrhythmic drugs were prescribed in 7.2% of patients with permanent AF, 2.9% of those with structural heart disease, and 0.0% of those with end-stage kidney disease. Catheter ablation was offered to 70% of patients with symptomatic paroxysmal or persistent AF after the failure or intolerance of 1 antiarrhythmic drug. All modifiable risk factors were documented in 59.3% of patients. Rates of all-cause mortality, ischemic stroke or transient ischemic attack, and major bleeding were 8.1, 0.8, and 2.56 per 100 patients/y, respectively. QIs for anticoagulation and outcomes were similar between general cardiology and tertiary referral centers. CONCLUSIONS: Although accredited centers in Spain demonstrated good performance in many of the ESC QIs for AF, there remains room for improvement. These data could serve as a starting point for enhancing the quality of care in this population.

Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Keywords

• Accreditation programs; Atrial fibrillation; Fibrilación auricular; Indicadores de calidad; Outcomes; Programas de acreditación; Quality indicators; Resultados