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Patients’ and Physicians’ Perceptions Regarding the Benefits of Atrial Fibrillation Ablation
Author(s) -
BADIN AUROA,
PARR ALAN R.,
BANGA SANDEEP,
WIGANT REBECCA R.,
BAMAN TIMIR S.
Publication year - 2017
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13014
Subject(s) - medicine , atrial fibrillation , logistic regression , stroke (engine) , confidence interval , odds ratio , ablation , multivariate analysis , cardiology , emergency medicine , mechanical engineering , engineering
Background It is unclear whether patients and physicians understand that atrial fibrillation ablation (AFA) has been shown to only improve symptomology and not reduce morbidity or mortality. Methods Note that 177 of 445 (40%) consecutive patients referred to an electrophysiology clinic for atrial fibrillation (AF) management responded anonymously to our survey via mail. Note that 105 of 656 (15%) physicians responded to our survey via email. Comparisons among groups were conducted using χ 2 test for categorical variables. Odds ratios and 95% confidence intervals were estimated by using a multivariate logistic regression model. Results Almost half of patients and physicians believed AF ablation (AFA) would eliminate the need for anticoagulation (43% vs. 44%, P > 0.05) while the majority of both groups believed AFA would improve survival (58% vs. 67%, P = 0.308). The great majority of both groups believed AFA would decrease stroke rates (89% vs. 80%, P = 0.106). When comparing noncardiologists (n = 86) to cardiologists (n = 19), noncardiologists were more likely to believe that an AFA would eliminate the need for anticoagulation 49% vs. 21% (X = 4.9, P = 0.04), improve survival 80% vs. 11% (X = 30.2, P < 0.001), and decrease stroke 87% vs. 44% (X = 15.6, P < 0.001), respectively. Conclusions The perceived benefit of AFA by patients and physicians is not supported by the medical literature. It is the responsibility of the electrophysiology community to educate patients and referring physicians regarding the true benefits of AFA. In addition, our study displays the great need for long‐term clinical trials examining the impact AFA has on morbidity and mortality.