Abstract 16415: Patterns of Atrial Fibrillation and Treatment Strategies Vary According to Provider Specialty Across Community Practice Settings: Findings From the ORBIT-AF Registry
Background: The numbers of patients with atrial fibrillation (AF) is growing rapidly, yet there are limited data on variation in AF presentation and treatment across various practice settings.
Methods: This study provides first insights from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), the largest longitudinal AF registry in the United States (US). AF patients were enrolled across a variety of ambulatory clinic practice settings including primary care, general cardiology, and electrophysiology (EP).
Results: To date, ORBIT-AF has enrolled 5474 AF patients from 138 US sites (36% internal medicine/primary care, 53% cardiology, and 10% EP). Overall, 43% of those enrolled were female, 90% were white, 5.2% were black, and 68% were Medicare beneficiaries. The median age was 76 (67, 82), the median (25th, 75th) CHADS2 score was 2 (1, 3) and the median (25th, 75th) CHADS2-VASc score was 4 (3, 5). Comorbidities were common with significant variance across provider specialty. Patients with heart failure were more common at cardiology and EP sites, while patients with prior stroke/TIA or GI bleed were more common at internal medicine (IM) sites (Table). The majority had paroxysmal AF (52%), although first-detected AF was most frequent among cardiology providers. Patients treated at EP sites were significantly younger, less often black, had fewer comorbidies, and were more likely to have paroxysmal versus persistent AF (Table). Rhythm control was most common at EP sites. For stroke prevention, warfarin (75%) use was consistent across provider specialty, yet patients treated by EP MDs were more likely to have their INR managed by anticoagulation clinics (Table).
Conclusions: AF presentation and management vary across provider specialty, particularly for rhythm control, anticoagulation monitoring, and the utilization of new therapies.
- © 2011 by American Heart Association, Inc.