Impact of atrial fibrillation centre on the implementation of the atrial fibrillation better care holistic pathway in a Chinese large teaching hospital: an interrupted time series analysis.

OBJECTIVES

Atrial fibrillation (AF) requires comprehensive management due to its complex nature. The Atrial Fibrillation Better Care (ABC) pathway, introduced in the 2020 European Society of Cardiology Guidelines, has demonstrated clinical benefits, yet adherence remains suboptimal. This study evaluates the impact of establishing an Atrial Fibrillation Centre (AFC) on ABC pathway adherence in a Chinese teaching hospital.

METHODS

This study employed an interrupted time series analysis to assess monthly ABC pathway adherence rates before and after AFC construction. The analysis focused on anticoagulation (A), better symptom control (B) and comorbidity management (C).

RESULTS

Following AFC establishment, the hospital-wide ABC adherence rate increased by 11.82%, with a sustained monthly increase of 0.27%. Improvements were primarily observed in cardiology and internal medicine departments, whereas surgical departments showed minimal change. Anticoagulation and symptom control adherence improved significantly, while comorbidity management remained unchanged.

DISCUSSION: The AFC improved ABC pathway adherence through standardised, multidisciplinary AF management. Significant gains in anticoagulation and symptom control were observed, but rhythm control and comorbidity management remained suboptimal. Barriers include limited ablation access and fragmented care. Future efforts should enhance interdisciplinary collaboration, expand procedural accessibility and integrate long-term cardiovascular risk management to optimise AF care.

CONCLUSION

Establishing an AFC significantly improved ABC pathway adherence, which proved effective in both stroke prevention and symptom management, particularly in cardiology and internal medicine departments. Future efforts should focus on enhancing rhythm control strategies and optimising comorbidity management to further improve integrated AF care.

TRIAL REGISTRATION NUMBER: MR-50-24-014759.