Survey on knowledge level of atrial fibrillation among general practitioners in Shanghai Pudong New Area / 中华全科医师杂志

ABSTRACT

Objective To survey the knowledge level of atrial fibrillation (AF) among general practitioners (GPs) in Shanghai Pudong New Area.Methods From July to September 2016,a stratified cluster sampling method was used to collect questionnaires from GPs who met the inclusion criteria in 12 community health service centers in Shanghai Pudong New Area.A self-made questionnaire was applied according to Current knowledge and management recommendations of atrial fibrillation-2015,which included 5 domainsantithrombotic therapy,rhythm control,ventricular rate control and evaluation of the guideline.Results A total of 377 questionnaires were distributed,and 371 were recovered.Among 371 participants there were 151 males and 220 females aged (41.3±8.3) years,including 156 (42.0％) with junior professional titles,158 (42.6％) with intermediate titles,and 57 (15.4％) with senior titles.More than 90％ of participants recognized that age,hypertension,myocardial infarction,and heart valve disease were risk factors of AF.For patient evaluation,54.2％ (201/371) of participants would use electrocardiogram,47.9％ (1 78/371) would use thyroid function,21.0％ (78/371) would use echocardiography,3.2％ (12/371) would use respiratory sleep monitoring,and 95.4％ (354/371) did not heard of cardiovascular implantable electronic devices.82.2％ (305/ 371) of participants thought rheumatic mitral stenosis,46.4％ (172/371) thought CHA2DS2-VASc score over and 2 and 12.7％ (47/371) thought hypertrophic cardiomyopathy as indications for anticoagulant;and 38.5％ (143/371) of participants rarely used CHA2DS2-VASc.The rhythm conversion would applied for the onset of atrial fibrillation in 42.9％ participants (159/371),for symptoms after the control of ventricular rate in 39.9％ (148/371) participants and for symptomatic patients in 12.7％ participants (47/371).59.8％ (222/371) of participants did not know the anticoagulation therapy for AF cardioversion,44.5％ (165/371) participants had not heard radiofrequency ablation for AF.38.5％ (143/371) of participants knew the Chinese guidelines for AF,of which 45.5％ (65/143) of the GPs used the guidelines;80.4％ (115/143) of the GPs thought the guide was very instructive.GPs with senior professional titles had better mastery of clinical evaluation,antithrombotic therapy,catheter ablation,and awareness of guideline than junior and middle-level general practitioners.Conclusion The survey shows that there is relative lack of knowledge on the risk factors,clinical assessment methods,anticoagulation indications and cardioversion anticoagulation therapy of AF,as well as lack of awareness and application of the AF guideline for GPs in Shanghai Pudong New Area.