Status of treatment for atrial fibrillation in a community health service center in Shanghai Pudong New Area / 中华全科医师杂志

ABSTRACT

Objective To analyze the status of the treatment for atrial fibrillation (AF) in a community health service center in Shanghai Pudong New Area. Methods Clinical data of all patients with AF attended in Hudong Community Health Service Center of Shanghai Pudong from August 2016 to August 2017 were retrospectively reviewed. The gender,age,smoking history,drinking history,concomitant diseases, antithrombotic therapy, rhythm control, ventricular rate control drugs, health education, needs for setting up AF clinics in the community were analyzed. Result The study included 220 patients,with average age of (59.7±10.4) years; 34.1％(75/220)patients had hypertension and the blood pressure was controlled in 41.3％(31/75); 20.5％(45/220)patients had diabetes mellitus and glycosylated hemoglobin(HbA1c)was controlled well in 26.7％(12/45). Three cases of mitral stenosis were treated with warfarin anticoagulation. Among 217 patients without valvular atrial fibrillation,157 had thromboembolic risk score≥2,20.4％ (32/157) of whom used warfarin anticoagulation,10.8％ (17/157) used new oral anticoagulant (NOAG) and 58.1％ (91/157) had never used warfarin or NOAG anticoagulation. The reasons were as followsdoctors did not prescribe (41.9％, 39/91),patients did not accept (35.2％,32/91), and so on. There were 21.8％ (48/220) of patients undergoing drug cardioversion,and 5.9％ (13/220) undergoing electrical cardioversion. For control of ventricular rate, 55.9％ (123/220) patients used beta blockers,13.6％ (30/220) used non?dihydropyridine calcium antagonists, and 23.6％ (52 / 220) used digitalise. Less than 55％ of patients were given health education of physical exercise,weight management and medicine use. For AF clinic in community hospital,56.8％ (125/220) of patients needed,and 17.3％ (38/220) very need; 50.0％ (110/220) patients trusted and 12.3％ (27/220) very trusted in anticoagulation management in community hospitals. Conclusion The anticoagulant rate is relatively low, treatment of concomitant diseases is less satisfactory and the health education might be incomplete in the community surveyed in this study.