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Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation : a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry. / Romiti, Giulio Francesco; Proietti, Marco; Vitolo, Marco et al.

In: BMC medicine, Vol. 20, No. 1, 326, 01.12.2022.

Research output: Contribution to journal › Article › Academic › peer-review

Harvard

Romiti, GF, Proietti, M, Vitolo, M, Bonini, N, Fawzy, AM, Ding, WY, Fauchier, L, Marin, F, Nabauer, M, Dan, GA, Potpara, TS, Boriani, G, Lip, GYH, on behalf of the ESC-EHRA EORP-AF General Long-Term Registry Investigators, Tavazzi, L, Maggioni, AP, Kalarus, Z, Ferrari, R, Shantsila, A, Goda, A, Mairesse, G, Shalganov, T, Antoniades, L, Taborsky, M, Riahi, S, Muda, P, García Bolao, I, Piot, O, Etsadashvili, K, Simantirakis, EN, Haim, M, Azhari, A, Najafian, J, Santini, M, Mirrakhimov, E, Kulzida, K, Erglis, A, Poposka, L, Burg, MR, Crijns, H, Erküner, Atar, D, Lenarczyk, R, Oliveira, MM, Shah, D, Serdechnaya, E, Diker, E, Lane, D, Zëra, E, Ekmekçiu, U, Paparisto, V, Tase, M, Gjergo, H, Dragoti, J, Goda, A, Ciutea, M, Ahadi, N, el Husseini, Z, Raepers, M, Leroy, J, Haushan, P, Jourdan, A, Lepiece, C, Desteghe, L, Vijgen, J, Koopman, P, van Genechten, G, Heidbuchel, H, Boussy, T, de Coninck, M, van Eeckhoutte, H, Bouckaert, N, Friart, A, Boreux, J, Arend, C, Evrard, P, Stefan, L, Hoffer, E, Herzet, J, Massoz, M, Celentano, C, Sprynger, M, Pierard, L, Melon, P, van Hauwaert, B, Kuppens, C, Faes, D, van Lier, D, van Dorpe, A, Gerardy, A, Deceuninck, O, Xhaet, O, Dormal, F, Ballant, E, Blommaert, D, Yakova, D, Hristov, M, Yncheva, T, Stancheva, N, Tisheva, S, Tokmakova, M, Nikolov, F, Gencheva, D, Shalganov, T, Kunev, B, Stoyanov, M, Marchov, D, Gelev, V, Traykov, V, Kisheva, A, Tsvyatkov, H, Shtereva, R, Bakalska-Georgieva, S, Slavcheva, S, Yotov, Y, Kubíčková, M, Joensen, AM, Gammelmark, A, Rasmussen, LH, Dinesen, P, Riahi, S, Venø, SK, Sorensen, B, Korsgaard, A, Andersen, K, Hellum, CF, Svenningsen, A, Nyvad, O, Wiggers, P, May, O, Aarup, A, Graversen, B, Jensen, L, Andersen, M, Svejgaard, M, Vester, S, Hansen, S, Lynggaard, V, Ciudad, M, Vettus, R, Muda, P, Maestre, A, Castaño, S, Cheggour, S, Poulard, J, Mouquet, V, Leparrée, S, Bouet, J, Taieb, J, Doucy, A, Duquenne, H, Furber, A, Dupuis, J, Rautureau, J, Font, M, Damiano, P, Lacrimini, M, Abalea, J, Boismal, S, Menez, T, Mansourati, J, Range, G, Gorka, H, Laure, C, Vassalière, C, Elbaz, N, Lellouche, N, Djouadi, K, Roubille, F, Dietz, D, Davy, J, Granier, M, Winum, P, Leperchois-Jacquey, C, Kassim, H, Marijon, E, le Heuzey, J, Fedida, J, Maupain, C, Himbert, C, Gandjbakhch, E, Hidden-Lucet, F, Duthoit, G, Badenco, N, Chastre, T, Waintraub, X, Oudihat, M, Lacoste, J, Stephan, C, Bader, H, Delarche, N, Giry, L, Arnaud, D, Lopez, C, Boury, F, Brunello, I, Lefèvre, M, Mingam, R, Haissaguerre, M, le Bidan, M, Pavin, D, le Moal, V, Leclercq, C, Piot, O, Beitar, T, Martel, I, Schmid, A, Sadki, N, Romeyer-Bouchard, C, da Costa, A, Arnault, I, Boyer, M, Piat, C, Lozance, N, Nastevska, S, Doneva, A, Fortomaroska Milevska, B, Sheshoski, B, Petroska, K, Taneska, N, Bakrecheski, N, Lazarovska, K, Jovevska, S, Ristovski, V, Antovski, A, Lazarova, E, Kotlar, I, Taleski, J, Poposka, L, Kedev, S, Zlatanovik, N, Jordanova, S, Bajraktarova Proseva, T, Doncovska, S, Maisuradze, D, Esakia, A, Sagirashvili, E, Lartsuliani, K, Natelashvili, N, Gumberidze, N, Gvenetadze, R, Etsadashvili, K, Gotonelia, N, Kuridze, N, Papiashvili, G, Menabde, I, Glöggler, S, Napp, A, Lebherz, C, Romero, H, Schmitz, K, Berger, M, Zink, M, Köster, S, Sachse, J, Vonderhagen, E, Soiron, G, Mischke, K, Reith, R, Schneider, M, Rieker, W, Boscher, D, Taschareck, A, Beer, A, Oster, D, Ritter, O, Adamczewski, J, Walter, S, Frommhold, A, Luckner, E, Richter, J, Schellner, M, Landgraf, S, Bartholome, S, Naumann, R, Schoeler, J, Westermeier, D, William, F, Wilhelm, K, Maerkl, M, Oekinghaus, R, Denart, M, Kriete, M, Tebbe, U, Scheibner, T, Gruber, M, Gerlach, A, Beckendorf, C, Anneken, L, Arnold, M, Lengerer, S, Bal, Z, Uecker, C, Förtsch, H, Fechner, S, Mages, V, Martens, E, Methe, H, Schmidt, T, Schaeffer, B, Hoffmann, B, Moser, J, Heitmann, K, Willems, S, Willems, S, Klaus, C, Lange, I, Durak, M, Esen, E, Mibach, F, Mibach, H, Utech, A, Gabelmann, M, Stumm, R, Ländle, V, Gartner, C, Goerg, C, Kaul, N, Messer, S, Burkhardt, D, Sander, C, Orthen, R, Kaes, S, Baumer, A, Dodos, F, Barth, A, Schaeffer, G, Gaertner, J, Winkler, J, Fahrig, A, Aring, J, Wenzel, I, Steiner, S, Kliesch, A, Kratz, E, Winter, K, Schneider, P, Haag, A, Mutscher, I, Bosch, R, Taggeselle, J, Meixner, S, Schnabel, A, Shamalla, A, Hötz, H, Korinth, A, Rheinert, C, Mehltretter, G, Schön, B, Schön, N, Starflinger, A, Englmann, E, Baytok, G, Laschinger, T, Ritscher, G, Gerth, A, Dechering, D, Eckardt, L, Kuhlmann, M, Proskynitopoulos, N, Brunn, J, Foth, K, Axthelm, C, Hohensee, H, Eberhard, K, Turbanisch, S, Hassler, N, Koestler, A, Stenzel, G, Kschiwan, D, Schwefer, M, Neiner, S, Hettwer, S, Haeussler-Schuchardt, M, Degenhardt, R, Sennhenn, S, Steiner, S, Brendel, M, Stoehr, A, Widjaja, W, Loehndorf, S, Logemann, A, Hoskamp, J, Grundt, J, Block, M, Ulrych, R, Reithmeier, A, Panagopoulos, V, Martignani, C, Bernucci, D, Fantecchi, E, Diemberger, I, Ziacchi, M, Biffi, M, Cimaglia, P, Frisoni, J, Giannini, I, Boni, S, Fumagalli, S, 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A, Czapla, W, Mróz, I, Kozlowski, M, Pawlowski, T, Tendera, M, Winiarska-Filipek, A, Fidyk, A, Slowikowski, A, Haberka, M, Lachor-Broda, M, Biedron, M, Gasior, Z, Kołodziej, M, Janion, M, Gorczyca-Michta, I, Wozakowska-Kaplon, B, Stasiak, M, Jakubowski, P, Ciurus, T, Drozdz, J, Simiera, M, Zajac, P, Wcislo, T, Zycinski, P, Kasprzak, J, Olejnik, A, Harc-Dyl, E, Miarka, J, Pasieka, M, Ziemińska-Łuć, M, Bujak, W, Śliwiński, A, Grech, A, Morka, J, Petrykowska, K, Prasał, M, Hordyński, G, Feusette, P, Lipski, P, Wester, A, Streb, W, Romanek, J, Woźniak, P, Chlebuś, M, Szafarz, P, Stanik, W, Zakrzewski, M, Kaźmierczak, J, Przybylska, A, Skorek, E, Błaszczyk, H, Stępień, M, Szabowski, S, Krysiak, W, Szymańska, M, Karasiński, J, Blicharz, J, Skura, M, Hałas, K, Michalczyk, L, Orski, Z, Krzyżanowski, K, Skrobowski, A, Zieliński, L, Tomaszewska-Kiecana, M, Dłużniewski, M, Kiliszek, M, Peller, M, Budnik, M, Balsam, P, Opolski, G, Tymińska, A, Ozierański, K, Wancerz, A, Borowiec, A, Majos, E, 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Djikic, D, Sipic, M, Peric, V, Dejanovic, B, Milosevic, N, Stevanovic, A, Andric, A, Pencic, B, Pavlovic-Kleut, M, Celic, V, Pavlovic, M, Petrovic, M, Vuleta, M, Petrovic, N, Simovic, S, Savovic, Z, Milanov, S, Davidovic, G, Iric-Cupic, V, Simonovic, D, Stojanovic, M, Stojanovic, S, Mitic, V, Ilic, V, Petrovic, D, Deljanin Ilic, M, Ilic, S, Stoickov, V, Markovic, S, Kovacevic, S, García Fernandez, A, Perez Cabeza, A, Anguita, M, Tercedor Sanchez, L, Mau, E, Loayssa, J, Ayarra, M, Carpintero, M, Roldán Rabadan, I, Leal, M, Ortega, MG, Tello Montoliu, A, Orenes Piñero, E, Manzano Fernández, S, Marín, F, Romero Aniorte, A, Veliz Martínez, A, Quintana Giner, M, Ballesteros, G, Palacio, M, Alcalde, O, García-Bolao, I, Bertomeu Gonzalez, V, Otero-Raviña, F, García Seara, J, Gonzalez Juanatey, J, Dayal, N, Maziarski, P, Gentil-Baron, P, Shah, D, Koç, M, Onrat, E, Dural, IE, Yilmaz, K, Özin, B, Kurklu, ST, Atmaca, Y, Canpolat, U, Tokgozoglu, L, Dolu, AK, Demirtas, B, Sahin, D, Ozcan Celebi, O, Diker, E, Gagirci, G, Turk, UO, Ari, H, Polat, N, Toprak, N, Sucu, M, Akin Serdar, O, Taha Alper, A, Kepez, A, Yuksel, Y, Uzunselvi, A, Yuksel, S, Sahin, M, Kayapinar, O, Ozcan, T, Kaya, H, Yilmaz, MB, Kutlu, M, Demir, M, Gibbs, C, Kaminskiene, S, Bryce, M, Skinner, A, Belcher, G, Hunt, J, Stancombe, L, Holbrook, B, Peters, C, Tettersell, S, Shantsila, A, Lane, D, Senoo, K, Russell, K, Domingos, P, Hussain, S, Partridge, J, Haynes, R, Bahadur, S, Brown, R, McMahon, S, McDonald, J, Balachandran, K, Singh, R, Garg, S, Desai, H, Davies, K, Goddard, W, Galasko, G, Rahman, I, Chua, Y, Payne, O, Preston, S, Brennan, O, Pedley, L, Whiteside, C, Dickinson, C, Brown, J, Jones, K, Benham, L, Brady, R, Buchanan, L, Ashton, A, Crowther, H, Fairlamb, H, Thornthwaite, S, Relph, C, McSkeane, A, Poultney, U, Kelsall, N, Rice, P, Wilson, T, Wrigley, M, Kaba, R, Patel, T, Young, E, Law, J, Runnett, C, Thomas, H, McKie, H, Fuller, J, Pick, S, Sharp, A, Hunt, A, Thorpe, K, Hardman, C, Cusack, E, Adams, L, Hough, M, Keenan, S, Bowring, A, Watts, J, Zaman, J, Goffin, K, Nutt, H, Beerachee, Y, Featherstone, J, Mills, C, Pearson, J, Stephenson, L, Grant, S, Wilson, A, Hawksworth, C, Alam, I, Robinson, M, Ryan, S, Egdell, R, Gibson, E, Holland, M, Leonard, D, Mishra, B, Ahmad, S, Randall, H, Hill, J, Reid, L, George, M, McKinley, S, Brockway, L, Milligan, W, Sobolewska, J, Muir, J, Tuckis, L, Winstanley, L, Jacob, P, Kaye, S, Morby, L, Jan, A, Sewell, T, Boos, C, Wadams, B, Cope, C, Jefferey, P, Andrews, N, Getty, A, Suttling, A, Turner, C, Hudson, K, Austin, R, Howe, S, Iqbal, R, Gandhi, N, Brophy, K, Mirza, P, Willard, E, Collins, S, Ndlovu, N, Subkovas, E, Karthikeyan, V, Waggett, L, Wood, A, Bolger, A, Stockport, J, Evans, L, Harman, E, Starling, J, Williams, L, Saul, V, Sinha, M, Bell, L, Tudgay, S, Kemp, S, Brown, J, Frost, L, Ingram, T, Loughlin, A, Adams, C, Adams, M, Hurford, F, Owen, C, Miller, C, Donaldson, D, Tivenan, H, Button, H, Nasser, A, Jhagra, O, Stidolph, B, Brown, C, Livingstone, C, Duffy, M, Madgwick, P, Roberts, P, Greenwood, E, Fletcher, L, Beveridge, M, Earles, S, McKenzie, D, Beacock, D, Dayer, M, Seddon, M, Greenwell, D, Luxton, F, Venn, F, Mills, H, Rewbury, J, James, K, Roberts, K, Tonks, L, Felmeden, D, Taggu, W, Summerhayes, A, Hughes, D, Sutton, J, Felmeden, L, Khan, M, Walker, E, Norris, L, O’Donohoe, L, Mozid, A, Dymond, H, Lloyd-Jones, H, Saunders, G, Simmons, D, Coles, D, Cotterill, D, Beech, S, Kidd, S, Wrigley, B, Petkar, S, Smallwood, A, Jones, R, Radford, E, Milgate, S, Metherell, S, Cottam, V, Buckley, C, Broadley, A, Wood, D, Allison, J, Rennie, K, Balian, L, Howard, L, Pippard, L, Board, S & Pitt-Kerby, T 2022, 'Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry', BMC medicine, vol. 20, no. 1, 326. https://doi.org/10.1186/s12916-022-02526-7

APA

Romiti, G. F., Proietti, M., Vitolo, M., Bonini, N., Fawzy, A. M., Ding, W. Y., Fauchier, L., Marin, F., Nabauer, M., Dan, G. A., Potpara, T. S., Boriani, G., Lip, G. Y. H., on behalf of the ESC-EHRA EORP-AF General Long-Term Registry Investigators, Tavazzi, L., Maggioni, A. P., Kalarus, Z., Ferrari, R., Shantsila, A., ... Pitt-Kerby, T. (2022). Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry. BMC medicine, 20(1), [326]. https://doi.org/10.1186/s12916-022-02526-7

Vancouver

Romiti GF, Proietti M, Vitolo M, Bonini N, Fawzy AM, Ding WY et al. Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry. BMC medicine. 2022 Dec 1;20(1):326. doi: 10.1186/s12916-022-02526-7

Author

Romiti, Giulio Francesco ; Proietti, Marco ; Vitolo, Marco et al. / Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation : a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry. In: BMC medicine. 2022 ; Vol. 20, No. 1.

BibTeX

@article{fe7a3f4fe09f4efba639ee8f2a46bc17,
title = "Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry",
abstract = "Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The {\textquoteleft}Atrial fibrillation Better Care{\textquoteright} (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients.",
keywords = "Atrial fibrillation, Clinical complexity, Integrated management, Outcomes",
author = "Romiti, {Giulio Francesco} and Marco Proietti and Marco Vitolo and Niccol{\`o} Bonini and Fawzy, {Ameenathul Mazaya} and Ding, {Wern Yew} and Laurent Fauchier and Francisco Marin and Michael Nabauer and Dan, {Gheorghe Andrei} and Potpara, {Tatjana S.} and Giuseppe Boriani and Lip, {Gregory Y. H.} and {on behalf of the ESC-EHRA EORP-AF General Long-Term Registry Investigators} and L. Tavazzi and Maggioni, {A. P.} and Z. Kalarus and R. Ferrari and A. Shantsila and A. Goda and G. Mairesse and T. Shalganov and L. Antoniades and M. Taborsky and S. Riahi and P. Muda and {Garc{\'i}a Bolao}, I. and O. Piot and K. Etsadashvili and Simantirakis, {E. N.} and M. Haim and A. Azhari and J. Najafian and M. Santini and E. Mirrakhimov and K. Kulzida and A. Erglis and L. Poposka and Burg, {M. R.} and H. Crijns and Erk{\"u}ner and D. Atar and R. Lenarczyk and Oliveira, {M. Martins} and D. Shah and E. Serdechnaya and E. Diker and D. Lane and E. Z{\"e}ra and U. Ekmek{\c c}iu and V. Paparisto and M. Tase and H. Gjergo and J. Dragoti and A. Goda and M. Ciutea and N. Ahadi and {el Husseini}, Z. and M. Raepers and J. Leroy and P. Haushan and A. Jourdan and C. Lepiece and L. Desteghe and J. Vijgen and P. Koopman and {van Genechten}, G. and H. Heidbuchel and T. Boussy and {de Coninck}, M. and {van Eeckhoutte}, H. and N. Bouckaert and A. Friart and J. Boreux and C. Arend and P. Evrard and L. Stefan and E. Hoffer and J. Herzet and M. Massoz and C. Celentano and M. Sprynger and L. Pierard and P. Melon and {van Hauwaert}, B. and C. Kuppens and D. Faes and {van Lier}, D. and {van Dorpe}, A. and A. Gerardy and O. Deceuninck and O. Xhaet and F. Dormal and E. Ballant and D. Blommaert and D. Yakova and M. Hristov and T. Yncheva and N. Stancheva and S. Tisheva and M. Tokmakova and F. Nikolov and D. Gencheva and T. Shalganov and B. Kunev and M. Stoyanov and D. Marchov and V. Gelev and V. Traykov and A. Kisheva and H. Tsvyatkov and R. Shtereva and S. Bakalska-Georgieva and S. Slavcheva and Y. Yotov and M. Kub{\'i}{\v c}kov{\'a} and Joensen, {A. Marni} and A. Gammelmark and Rasmussen, {L. Hvilsted} and P. Dinesen and S. Riahi and Ven{\o}, {S. Krogh} and B. Sorensen and A. Korsgaard and K. Andersen and Hellum, {C. Fragtrup} and A. Svenningsen and O. Nyvad and P. Wiggers and O. May and A. Aarup and B. Graversen and L. Jensen and M. Andersen and M. Svejgaard and S. Vester and S. Hansen and V. Lynggaard and M. Ciudad and R. Vettus and P. Muda and A. Maestre and S. Casta{\~n}o and S. Cheggour and J. Poulard and V. Mouquet and S. Leparr{\'e}e and J. Bouet and J. Taieb and A. Doucy and H. Duquenne and A. Furber and J. Dupuis and J. Rautureau and M. Font and P. Damiano and M. Lacrimini and J. Abalea and S. Boismal and T. Menez and J. Mansourati and G. Range and H. Gorka and C. Laure and C. Vassali{\`e}re and N. Elbaz and N. Lellouche and K. Djouadi and F. Roubille and D. Dietz and J. Davy and M. Granier and P. Winum and C. Leperchois-Jacquey and H. Kassim and E. Marijon and {le Heuzey}, J. and J. Fedida and C. Maupain and C. Himbert and E. Gandjbakhch and F. Hidden-Lucet and G. Duthoit and N. Badenco and T. Chastre and X. Waintraub and M. Oudihat and J. Lacoste and C. Stephan and H. Bader and N. Delarche and L. Giry and D. Arnaud and C. Lopez and F. Boury and I. Brunello and M. Lef{\`e}vre and R. Mingam and M. Haissaguerre and {le Bidan}, M. and D. Pavin and {le Moal}, V. and C. Leclercq and O. Piot and T. Beitar and I. Martel and A. Schmid and N. Sadki and C. Romeyer-Bouchard and {da Costa}, A. and I. Arnault and M. Boyer and C. Piat and N. Lozance and S. Nastevska and A. Doneva and {Fortomaroska Milevska}, B. and B. Sheshoski and K. Petroska and N. Taneska and N. Bakrecheski and K. Lazarovska and S. Jovevska and V. Ristovski and A. Antovski and E. Lazarova and I. Kotlar and J. Taleski and L. Poposka and S. Kedev and N. Zlatanovik and S. Jordanova and {Bajraktarova Proseva}, T. and S. Doncovska and D. Maisuradze and A. Esakia and E. Sagirashvili and K. Lartsuliani and N. Natelashvili and N. Gumberidze and R. Gvenetadze and K. Etsadashvili and N. Gotonelia and N. Kuridze and G. Papiashvili and I. Menabde and S. Gl{\"o}ggler and A. Napp and C. Lebherz and H. Romero and K. Schmitz and M. Berger and M. Zink and S. K{\"o}ster and J. Sachse and E. Vonderhagen and G. Soiron and K. Mischke and R. Reith and M. Schneider and W. Rieker and D. Boscher and A. Taschareck and A. Beer and D. Oster and O. Ritter and J. Adamczewski and S. Walter and A. Frommhold and E. Luckner and J. Richter and M. Schellner and S. Landgraf and S. Bartholome and R. Naumann and J. Schoeler and D. Westermeier and F. William and K. Wilhelm and M. Maerkl and R. Oekinghaus and M. Denart and M. Kriete and U. Tebbe and T. Scheibner and M. Gruber and A. Gerlach and C. Beckendorf and L. Anneken and M. Arnold and S. Lengerer and Z. Bal and C. Uecker and H. F{\"o}rtsch and S. Fechner and V. Mages and E. Martens and H. Methe and T. Schmidt and B. Schaeffer and B. Hoffmann and J. Moser and K. Heitmann and S. Willems and S. Willems and C. Klaus and I. Lange and M. Durak and E. Esen and F. Mibach and H. Mibach and A. Utech and M. Gabelmann and R. Stumm and V. L{\"a}ndle and C. Gartner and C. Goerg and N. Kaul and S. Messer and D. Burkhardt and C. Sander and R. Orthen and S. Kaes and A. Baumer and F. Dodos and A. Barth and G. Schaeffer and J. Gaertner and J. Winkler and A. Fahrig and J. Aring and I. Wenzel and S. Steiner and A. Kliesch and E. Kratz and K. Winter and P. Schneider and A. Haag and I. Mutscher and R. Bosch and J. Taggeselle and S. Meixner and A. Schnabel and A. Shamalla and H. H{\"o}tz and A. Korinth and C. Rheinert and G. Mehltretter and B. Sch{\"o}n and N. Sch{\"o}n and A. Starflinger and E. Englmann and G. Baytok and T. Laschinger and G. Ritscher and A. Gerth and D. Dechering and L. Eckardt and M. Kuhlmann and N. Proskynitopoulos and J. Brunn and K. Foth and C. Axthelm and H. Hohensee and K. Eberhard and S. Turbanisch and N. Hassler and A. Koestler and G. Stenzel and D. Kschiwan and M. Schwefer and S. Neiner and S. Hettwer and M. Haeussler-Schuchardt and R. Degenhardt and S. Sennhenn and S. Steiner and M. Brendel and A. Stoehr and W. Widjaja and S. Loehndorf and A. Logemann and J. Hoskamp and J. Grundt and M. Block and R. Ulrych and A. Reithmeier and V. Panagopoulos and C. Martignani and D. Bernucci and E. Fantecchi and I. Diemberger and M. Ziacchi and M. Biffi and P. Cimaglia and J. Frisoni and I. Giannini and S. Boni and S. Fumagalli and S. Pupo and {di Chiara}, A. and P. Mirone and E. Fantecchi and F. Pesce and C. Zoccali and Malavasi, {V. L.} and A. Mussagaliyeva and B. Ahyt and Z. Salihova and K. Koshum-Bayeva and A. Kerimkulova and A. Bairamukova and E. Mirrakhimov and B. Lurina and R. Zuzans and S. Jegere and I. Mintale and K. Kupics and K. Jubele and A. Erglis and O. Kalejs and K. Vanhear and M. Burg and M. Cachia and E. Abela and S. Warwicker and T. Tabone and R. Xuereb and D. Asanovic and D. Drakalovic and M. Vukmirovic and N. Pavlovic and L. Music and N. Bulatovic and A. Boskovic and H. Uiterwaal and N. Bijsterveld and {de Groot}, J. and J. Neefs and {van den Berg}, N. and F. Piersma and A. Wilde and V. Hagens and {van Es}, J. and {van Opstal}, J. and {van Rennes}, B. and H. Verheij and W. Breukers and G. Tjeerdsma and R. Nijmeijer and D. Wegink and R. Binnema and S. Said and Erk{\"u}ner and S. Philippens and {van Doorn}, W. and H. Crijns and T. Szili-Torok and R. Bhagwandien and P. Janse and A. Muskens and {van Eck}, M. and R. Gevers and {van der Ven}, N. and A. Duygun and B. Rahel and J. Meeder and A. Vold and {Holst Hansen}, C. and I. Engset and D. Atar and B. Dyduch-Fejklowicz and E. Koba and M. Cichocka and A. Sokal and A. Kubicius and E. Pruchniewicz and A. Kowalik-Sztylc and W. Czapla and I. Mr{\'o}z and M. Kozlowski and T. Pawlowski and M. Tendera and A. Winiarska-Filipek and A. Fidyk and A. Slowikowski and M. Haberka and M. Lachor-Broda and M. Biedron and Z. Gasior and M. Ko{\l}odziej and M. Janion and I. Gorczyca-Michta and B. Wozakowska-Kaplon and M. Stasiak and P. Jakubowski and T. Ciurus and J. Drozdz and M. Simiera and P. Zajac and T. Wcislo and P. Zycinski and J. Kasprzak and A. Olejnik and E. Harc-Dyl and J. Miarka and M. Pasieka and M. Ziemi{\'n}ska-{\L}u{\'c} and W. Bujak and A. {\'S}liwi{\'n}ski and A. Grech and J. Morka and K. Petrykowska and M. Prasa{\l} and G. Hordy{\'n}ski and P. Feusette and P. Lipski and A. Wester and W. Streb and J. Romanek and P. Wo{\'z}niak and M. Chlebu{\'s} and P. Szafarz and W. Stanik and M. Zakrzewski and J. Ka{\'z}mierczak and A. Przybylska and E. Skorek and H. B{\l}aszczyk and M. St{\c e}pie{\'n} and S. Szabowski and W. Krysiak and M. Szyma{\'n}ska and J. Karasi{\'n}ski and J. Blicharz and M. Skura and K. Ha{\l}as and L. Michalczyk and Z. Orski and K. Krzy{\.z}anowski and A. Skrobowski and L. Zieli{\'n}ski and M. Tomaszewska-Kiecana and M. D{\l}u{\.z}niewski and M. Kiliszek and M. Peller and M. Budnik and P. Balsam and G. Opolski and A. Tymi{\'n}ska and K. Oziera{\'n}ski and A. Wancerz and A. Borowiec and E. Majos and R. Dabrowski and H. Szwed and A. Musialik-Lydka and A. Leopold-Jadczyk and E. Jedrzejczyk-Patej and M. Koziel and R. Lenarczyk and M. Mazurek and Z. Kalarus and K. Krzemien-Wolska and P. Starosta and E. Nowalany-Kozielska and A. Orzechowska and M. Szpot and M. Staszel and S. Almeida and H. Pereira and {Brand{\~a}o Alves}, L. and R. Miranda and L. Ribeiro and F. Costa and F. Morgado and P. Carmo and {Galvao Santos}, P. and R. Bernardo and P. Adrag{\~a}o and {Ferreira da Silva}, G. and M. Peres and M. Alves and M. Leal and A. Cordeiro and P. Magalh{\~a}es and P. Fontes and S. Le{\~a}o and A. Delgado and A. Costa and B. Marmelo and B. Rodrigues and D. Moreira and J. Santos and L. Santos and A. Terchet and D. Darabantiu and S. Mercea and {Turcin Halka}, V. and {Pop Moldovan}, A. and A. Gabor and B. Doka and G. Catanescu and H. Rus and L. Oboroceanu and E. Bobescu and R. Popescu and A. Dan and A. Buzea and I. Daha and G. Dan and I. Neuhoff and M. Baluta and R. Ploesteanu and N. Dumitrache and M. Vintila and A. Daraban and C. Japie and E. Badila and H. Tewelde and M. Hostiuc and S. Frunza and E. Tintea and D. Bartos and A. Ciobanu and I. Popescu and N. Toma and C. Gherghinescu and D. Cretu and N. Patrascu and C. Stoicescu and C. Udroiu and G. Bicescu and V. Vintila and D. Vinereanu and M. Cinteza and R. Rimbas and M. Grecu and A. Cozma and F. Boros and M. Ille and O. Tica and R. Tor and A. Corina and A. Jeewooth and B. Maria and C. Georgiana and C. Natalia and D. Alin and D. Dinu-Andrei and M. Livia and R. Daniela and R. Larisa and S. Umaar and T. Tamara and Popescu, {M. Ioachim} and D. Nistor and I. Sus and O. Coborosanu and N. Alina-Ramona and R. Dan and L. Petrescu and G. Ionescu and I. Popescu and C. Vacarescu and E. Goanta and M. Mangea and A. Ionac and C. Mornos and D. Cozma and S. Pescariu and E. Solodovnicova and I. Soldatova and J. Shutova and L. Tjuleneva and T. Zubova and V. Uskov and D. Obukhov and G. Rusanova and I. Soldatova and N. Isakova and S. Odinsova and T. Arhipova and E. Kazakevich and E. Serdechnaya and O. Zavyalova and T. Novikova and I. Riabaia and S. Zhigalov and E. Drozdova and I. Luchkina and Y. Monogarova and D. Hegya and L. Rodionova and L. Rodionova and V. Nevzorova and I. Soldatova and O. Lusanova and A. Arandjelovic and D. Toncev and M. Milanov and N. Sekularac and M. Zdravkovic and S. Hinic and S. Dimkovic and T. Acimovic and J. Saric and M. Polovina and B. Vujisic-Tesic and M. Nedeljkovic and M. Zlatar and M. Asanin and V. Vasic and Z. Popovic and D. Djikic and M. Sipic and V. Peric and B. Dejanovic and N. Milosevic and A. Stevanovic and A. Andric and B. Pencic and M. Pavlovic-Kleut and V. Celic and M. Pavlovic and M. Petrovic and M. Vuleta and N. Petrovic and S. Simovic and Z. Savovic and S. Milanov and G. Davidovic and V. Iric-Cupic and D. Simonovic and M. Stojanovic and S. Stojanovic and V. Mitic and V. Ilic and D. Petrovic and {Deljanin Ilic}, M. and S. Ilic and V. Stoickov and S. Markovic and S. Kovacevic and {Garc{\'i}a Fernandez}, A. and {Perez Cabeza}, A. and M. Anguita and {Tercedor Sanchez}, L. and E. Mau and J. Loayssa and M. Ayarra and M. Carpintero and {Rold{\'a}n Rabadan}, I. and M. Leal and Ortega, {M. Gil} and {Tello Montoliu}, A. and {Orenes Pi{\~n}ero}, E. and {Manzano Fern{\'a}ndez}, S. and F. Mar{\'i}n and {Romero Aniorte}, A. and {Veliz Mart{\'i}nez}, A. and {Quintana Giner}, M. and G. Ballesteros and M. Palacio and O. Alcalde and I. Garc{\'i}a-Bolao and {Bertomeu Gonzalez}, V. and F. Otero-Ravi{\~n}a and {Garc{\'i}a Seara}, J. and {Gonzalez Juanatey}, J. and N. Dayal and P. Maziarski and P. Gentil-Baron and D. Shah and M. Ko{\c c} and E. Onrat and Dural, {I. E.} and K. Yilmaz and B. {\"O}zin and Kurklu, {S. Tan} and Y. Atmaca and U. Canpolat and L. Tokgozoglu and Dolu, {A. K.} and B. Demirtas and D. Sahin and {Ozcan Celebi}, O. and E. Diker and G. Gagirci and Turk, {U. O.} and H. Ari and N. Polat and N. Toprak and M. Sucu and {Akin Serdar}, O. and {Taha Alper}, A. and A. Kepez and Y. Yuksel and A. Uzunselvi and S. Yuksel and M. Sahin and O. Kayapinar and T. Ozcan and H. Kaya and Yilmaz, {M. B.} and M. Kutlu and M. Demir and C. Gibbs and S. Kaminskiene and M. Bryce and A. Skinner and G. Belcher and J. Hunt and L. Stancombe and B. Holbrook and C. Peters and S. Tettersell and A. Shantsila and D. Lane and K. Senoo and K. Russell and P. Domingos and S. Hussain and J. Partridge and R. Haynes and S. Bahadur and R. Brown and S. McMahon and J. McDonald and K. Balachandran and R. Singh and S. Garg and H. Desai and K. Davies and W. Goddard and G. Galasko and I. Rahman and Y. Chua and O. Payne and S. Preston and O. Brennan and L. Pedley and C. Whiteside and C. Dickinson and J. Brown and K. Jones and L. Benham and R. Brady and L. Buchanan and A. Ashton and H. Crowther and H. Fairlamb and S. Thornthwaite and C. Relph and A. McSkeane and U. Poultney and N. Kelsall and P. Rice and T. Wilson and M. Wrigley and R. Kaba and T. Patel and E. Young and J. Law and C. Runnett and H. Thomas and H. McKie and J. Fuller and S. Pick and A. Sharp and A. Hunt and K. Thorpe and C. Hardman and E. Cusack and L. Adams and M. Hough and S. Keenan and A. Bowring and J. Watts and J. Zaman and K. Goffin and H. Nutt and Y. Beerachee and J. Featherstone and C. Mills and J. Pearson and L. Stephenson and S. Grant and A. Wilson and C. Hawksworth and I. Alam and M. Robinson and S. Ryan and R. Egdell and E. Gibson and M. Holland and D. Leonard and B. Mishra and S. Ahmad and H. Randall and J. Hill and L. Reid and M. George and S. McKinley and L. Brockway and W. Milligan and J. Sobolewska and J. Muir and L. Tuckis and L. Winstanley and P. Jacob and S. Kaye and L. Morby and A. Jan and T. Sewell and C. Boos and B. Wadams and C. Cope and P. Jefferey and N. Andrews and A. Getty and A. Suttling and C. Turner and K. Hudson and R. Austin and S. Howe and R. Iqbal and N. Gandhi and K. Brophy and P. Mirza and E. Willard and S. Collins and N. Ndlovu and E. Subkovas and V. Karthikeyan and L. Waggett and A. Wood and A. Bolger and J. Stockport and L. Evans and E. Harman and J. Starling and L. Williams and V. Saul and M. Sinha and L. Bell and S. Tudgay and S. Kemp and J. Brown and L. Frost and T. Ingram and A. Loughlin and C. Adams and M. Adams and F. Hurford and C. Owen and C. Miller and D. Donaldson and H. Tivenan and H. Button and A. Nasser and O. Jhagra and B. Stidolph and C. Brown and C. Livingstone and M. Duffy and P. Madgwick and P. Roberts and E. Greenwood and L. Fletcher and M. Beveridge and S. Earles and D. McKenzie and D. Beacock and M. Dayer and M. Seddon and D. Greenwell and F. Luxton and F. Venn and H. Mills and J. Rewbury and K. James and K. Roberts and L. Tonks and D. Felmeden and W. Taggu and A. Summerhayes and D. Hughes and J. Sutton and L. Felmeden and M. Khan and E. Walker and L. Norris and L. O{\textquoteright}Donohoe and A. Mozid and H. Dymond and H. Lloyd-Jones and G. Saunders and D. Simmons and D. Coles and D. Cotterill and S. Beech and S. Kidd and B. Wrigley and S. Petkar and A. Smallwood and R. Jones and E. Radford and S. Milgate and S. Metherell and V. Cottam and C. Buckley and A. Broadley and D. Wood and J. Allison and K. Rennie and L. Balian and L. Howard and L. Pippard and S. Board and T. Pitt-Kerby",
note = "Funding Information: MP is an investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation programme under grant agreement No 899871. LF has been a consultant and speaker for AstraZeneca, Bayer, BMS/Pfizer, Boehringer Ingelheim, Medtronic, Novartis, Novo, XO and Zoll. FM is a consultant for Bayer and Boehringer-Ingelheim; FM received small research{\textquoteright}s fees from AFNET, Ferrer, Astra-Zeneca, Boehringer-Ingelheim and Bayer; FM is an investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation programme under grant agreement No 899871. TSP is a consultant for Bayer and Pfizer, with no fees received personally; GB a received small speaker{\textquoteright}s fees from Medtronic, Boston, Boehringer Ingelheim and Bayer; GYHL is a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim and Daiichi-Sankyo. No fees are received personally. GYHL is co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation programme under grant agreement No 899871. Funding Information: EORP Oversight Committee, Executive and Steering Committees (National Coordinators) of the EURObservational Research Programme (EORP)—Atrial Fibrillation General Long-Term (EORP-AFGen LT) Registry of the European Society of Cardiology (ESC). Data collection was conducted by the EORP department by Patti-Ann McNeill as Project Officer and Viviane Missiamenou as Data Manager. Overall activities were coordinated and supervised by Doctor Aldo P. Maggioni (EORP Scientific Coordinator). EURObservational Research Programme Atrial Fibrillation (EORP-AF) Long-Term General Registry Investigators Executive committee : G. Boriani (Chair), G.Y.H. Lip, L. Tavazzi, A. P. Maggioni, G-A. Dan, T. Potpara, M. Nabauer, F. Marin, Z. Kalarus, L. Fauchier, R. Ferrari, A. Shantsila. Steering Committee (National Coordinators) : A. Goda, University Hospital Center {\textquoteleft}Mother Tereza{\textquoteright}, Tirana, Albania ; G. Mairesse, Cliniques du Sud-Luxembourg, Arlon, Belgium; T. Shalganov, National Heart Hospital, Sofia, Bulgaria; L. Antoniades, Nicosia General Hospital, Latsia, Cyprus; M. Taborsky, University Hospital Olomouc, Olomouc, Czech Republic; S. Riahi, Aalborg University Hospital, Aalborg, Denmark; P. Muda, University of Tartu, Tartu, Estonia; I. Garc{\'i}a Bolao, Navarra Institute for Health Research, Pamplona, Spain; O. Piot, Centre Cardiologique du Nord, Saint-Denis, France; M. Nabauer, Ludwig-Maximilians-University, Munich, Germany; K. Etsadashvili, G. Chapidze Emergency Cardiology Center, Tbilisi, Georgia; EN. Simantirakis, University Hospital of Heraklion, School of Medicine, University of Crete, Heraklion, Crete, Greece; M. Haim, Soroka Medical Center, Beer Sheva, Israel; A. Azhari, J. Najafian, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; M. Santini, San Filippo Neri Hospital, Rome, Italy; E. Mirrakhimov, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan; K. Kulzida, Scientific-Research Institute of Cardiology and Internal Diseases, Almaty, Republic of Kazakhstan; A. Erglis, Pauls Stradins Clinical University Hospital University of Latvia Riga Latvia; L. Poposka, University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia; MR. Burg, Mater Dei Hospital, Triq Dun Karm Psaila, Malta; H. Crijns, {\"O}. Erk{\"u}ner, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands; D. Atar, Oslo University Hospital Ullev{\aa}l and Institute of Clinical Sciences, University of Oslo, Oslo, Norway; R. Lenarczyk, Silesian Center for Heart Disease, Zabrze, Poland; M. Martins Oliveira, Hospital Santa Marta, Lisbon, Portugal; D. Shah, Department of Medicine Specialities, University Hospital Geneva, Geneva, Switzerland; G-A. Dan, Colentina University Hospital, Bucharest, Romania; E. Serdechnaya, Northern State Medical University, Arkhangelsk, Russia; T. Potpara, Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia; E. Diker, Ba{\c s}ak{\c s}ehir {\c C}am and Sakura City Hospital, Istanbul, Turkey; G.Y.H. Lip, D. Lane; City Hospital, University of Birmingham, Birmingham, United Kingdom. Investigators : Albania —Durr{\"e}s: E. Z{\"e}ra; Tirana: U. Ekmek{\c c}iu, V. Paparisto, M. Tase; Tirana: H. Gjergo, J. Dragoti, A. Goda. Belgium— Bastogne: M. Ciutea, N. Ahadi, Z. el Husseini, M. Raepers; Gilly: J. Leroy, P. Haushan, A. Jourdan; Haine Saint Paul: C. Lepiece; Hasselt: L. Desteghe, J. Vijgen, P. Koopman, G. Van Genechten, H. Heidbuchel; Kortrijk: T. Boussy, M. De Coninck, H. Van Eeckhoutte, N. Bouckaert; La Louviere: A. Friart, J. Boreux, C. Arend; Liege: P. Evrard; Li{\`e}ge: L. Stefan, E. Hoffer, J. Herzet, M. Massoz; Li{\`e}ge: C. Celentano, M. Sprynger, L. Pierard; Li{\`e}ge: P. Melon; Overpelt: B. Van Hauwaert, C. Kuppens, D. Faes, D. Van Lier, A. Van Dorpe; Waremme: A. Gerardy; Yvoir: O. Deceuninck, O. Xhaet, F. Dormal, E. Ballant, D. Blommaert. Bulgaria— Pleven: D. Yakova, M. Hristov, T. Yncheva, N. Stancheva, S. Tisheva; Plovdiv: M. Tokmakova, F. Nikolov, D. Gencheva; Sofia: T. Shalganov, B. Kunev, M. Stoyanov; Sofia: D. Marchov, V. Gelev, V. Traykov; Varna: A. Kisheva, H. Tsvyatkov, R. Shtereva, S. Bakalska-Georgieva, S. Slavcheva, Y. Yotov. Czech Republic— {\'U}st{\'i} nad Labem: M. Kub{\'i}{\v c}kov{\'a}. Denmark— Aalborg: A. Marni Joensen, A. Gammelmark, L. Hvilsted Rasmussen, P. Dinesen, S. Riahi, S. Krogh Ven{\o}, B. Sorensen, A. Korsgaard, K. Andersen, C. Fragtrup Hellum; Esbjerg: A. Svenningsen, O. Nyvad, P. Wiggers; Herning: O. May, A. Aarup, B. Graversen, L. Jensen, M. Andersen, M. Svejgaard, S. Vester, S. Hansen, V. Lynggaard. Estonia— Tallinn: R. Vettus; Tartu: P. Muda. Elche, Alicante: A. Maestre; Toledo: S. Casta{\~n}o. France— Abbeville: S. Cheggour; Abbeville: J. Poulard, V. Mouquet, S. Leparr{\'e}e; Aix-en-Provence: J. Bouet, J. Taieb; Amiens: A. Doucy, H. Duquenne; Angers: A. Furber, J. Dupuis, J. Rautureau; Aurillac: M. Font, P. Damiano; Avignon Cedex: M. Lacrimini; Brest: J. Abalea, S. Boismal, T. Menez, J. Mansourati; Chartres: G. Range, H. Gorka, C. Laure, C. Vassali{\`e}re; Creteil: N. Elbaz, N. Lellouche, K. Djouadi; Montpellier: F. Roubille, D. Dietz, J. Davy; Nimes: M. Granier, P. Winum, C. Leperchois-Jacquey; Paris: H. Kassim, E. Marijon, J. Le Heuzey; Paris: J. Fedida, C. Maupain, C. Himbert, E. Gandjbakhch, F. Hidden-Lucet, G. Duthoit, N. Badenco, T. Chastre, X. Waintraub, M. Oudihat, J. Lacoste, C. Stephan; Pau: H. Bader, N. Delarche, L. Giry; Pessac: D. Arnaud, C. Lopez, F. Boury, I. Brunello, M. Lef{\`e}vre, R. Mingam, M. Haissaguerre; Rennes: M. Le Bidan, D. Pavin, V. Le Moal, C. Leclercq; Saint Denis: O. Piot, T. Beitar; Saint Etienne: I. Martel, A. Schmid, N. Sadki, C. Romeyer-Bouchard, A. Da Costa; Tours: I. Arnault, M. Boyer, C. Piat, L. Fauchier. FYR Macedonia —Bitola: N. Lozance, S. Nastevska; Ohrid: A. Doneva, B. Fortomaroska Milevska, B. Sheshoski, K. Petroska, N. Taneska, N. Bakrecheski; Skopje: K. Lazarovska, S. Jovevska, V. Ristovski, A. Antovski; Skopje: E. Lazarova, I. Kotlar, J. Taleski, L. Poposka, S. Kedev; Skopje: N. Zlatanovik; {\v S}tip: S. Jordanova, T. Bajraktarova Proseva, S. Doncovska. Georgia— Tbilisi: D. Maisuradze, A. Esakia, E. Sagirashvili, K. Lartsuliani, N. Natelashvili, N. Gumberidze, R. Gvenetadze; Tbilisi: K. Etsadashvili, N. Gotonelia, N. Kuridze; Tbilisi: G. Papiashvili, I. Menabde. Germany— Aachen: S. Gl{\"o}ggler, A. Napp, C. Lebherz, H. Romero, K. Schmitz, M. Berger, M. Zink, S. K{\"o}ster, J. Sachse, E. Vonderhagen, G. Soiron, K. Mischke; Bad Reichenhall: R. Reith, M. Schneider; Berlin: W. Rieker; Biberach: D. Boscher, A. Taschareck, A. Beer; Boppard: D. Oster; Brandenburg: O. Ritter, J. Adamczewski, S. Walter; Chemnitz: A. Frommhold, E. Luckner, J. Richter, M. Schellner, S. Landgraf, S. Bartholome; Chemnitz: R. Naumann, J. Schoeler; Dachau: D. Westermeier, F. William, K. Wilhelm, M. Maerkl; Detmold: R. Oekinghaus, M. Denart, M. Kriete, U. Tebbe; Ebersbach: T. Scheibner; Erlangen: M. Gruber, A. Gerlach, C. Beckendorf, L. Anneken, M. Arnold, S. Lengerer, Z. Bal, C. Uecker, H. F{\"o}rtsch, S. Fechner, V. Mages; Friedberg: E. Martens, H. Methe; G{\"o}ttingen: T. Schmidt; Hamburg: B. Schaeffer, B. Hoffmann, J. Moser, K. Heitmann, S. Willems, S. Willems; Hartmannsdorf: C. Klaus, I. Lange; Heidelberg: M. Durak, E. Esen; Itzehoe: F. Mibach, H. Mibach; Kassel: A. Utech; Kirchzarten: M. Gabelmann, R. Stumm, V. L{\"a}ndle; Koblenz: C. Gartner, C. Goerg, N. Kaul, S. Messer, D. Burkhardt, C. Sander, R. Orthen, S. Kaes; K{\"o}ln: A. Baumer, F. Dodos; K{\"o}nigsbr{\"u}ck: A. Barth, G. Schaeffer; Leisnig: J. Gaertner, J. Winkler; Leverkusen: A. Fahrig, J. Aring, I. Wenzel; Limburg: S. Steiner, A. Kliesch, E. Kratz, K. Winter, P. Schneider; Ludwigsburg: A. Haag, I. Mutscher, R. Bosch; Markkleeberg: J. Taggeselle, S. Meixner; Meissen: A. Schnabel; Meppen: A. Shamalla, H. H{\"o}tz, A. Korinth; Merzig: C. Rheinert; Moosburg: G. Mehltretter; M{\"u}hldorf: B. Sch{\"o}n, N. Sch{\"o}n, A. Starflinger, E. Englmann; Munich: G. Baytok, T. Laschinger, G. Ritscher; Munich: A. Gerth; M{\"u}nster: D. Dechering, L. Eckardt; Nienburg: M. Kuhlmann, N. Proskynitopoulos; Paderborn: J. Brunn, K. Foth; Pirna: C. Axthelm, H. Hohensee, K. Eberhard, S. Turbanisch; Plauen: N. Hassler, A. Koestler; Riesa: G. Stenzel; Riesa: D. Kschiwan, M. Schwefer, S. Neiner, S. Hettwer; Rotenburg a.d. Fulda: M. Haeussler-Schuchardt, R. Degenhardt, S. Sennhenn, S. Steiner; Starnberg: M. Brendel; Westerstede: A. Stoehr, W. Widjaja, S. Loehndorf, A. Logemann, J. Hoskamp, J. Grundt; Zorneding: M. Block; Zwiesel: R. Ulrych, A. Reithmeier, V. Panagopoulos. Italy— Bologna: C. Martignani, D. Bernucci, E. Fantecchi, I. Diemberger, M. Ziacchi, M. Biffi, P. Cimaglia, J. Frisoni, G. Boriani; Firenze: I. Giannini, S. Boni, S. Fumagalli, S. Pupo, A. Di Chiara, P. Mirone; Modena: E. Fantecchi, G. Boriani, F. Pesce, C. Zoccali, V.L. Malavasi. Kazakhstan— Almaty: A. Mussagaliyeva, B. Ahyt, Z. Salihova, K. Koshum-Bayeva. Kyrgyzstan— Bishkek: A. Kerimkulova, A. Bairamukova, E. Mirrakhimov. Latvia— Riga: B. Lurina, R. Zuzans, S. Jegere, I. Mintale, K. Kupics, K. Jubele, A. Erglis, O. Kalejs. Malta— Birkirkara: K. Vanhear, M. Burg, M. Cachia, E. Abela, S. Warwicker, T. Tabone, R. Xuereb. Montenegro— Podgorica: D. Asanovic, D. Drakalovic, M. Vukmirovic, N. Pavlovic, L. Music, N. Bulatovic, A. Boskovic. Netherlands— Almere: H. Uiterwaal, N. Bijsterveld; Amsterdam: J. De Groot, J. Neefs, N. van den Berg, F. Piersma, A. Wilde; Delfzijl: V. Hagens; Enschede: J. Van Es, J. Van Opstal, B. Van Rennes, H. Verheij, W. Breukers; Heerenveen: G. Tjeerdsma, R. Nijmeijer, D. Wegink, R. Binnema; Hengelo: S. Said; Maastricht: {\"O}. Erk{\"u}ner, S. Philippens, W. van Doorn, H. Crijns; Rotterdam: T. Szili-Torok, R. Bhagwandien, P. Janse, A. Muskens; s-Hertogenbosch: M. van Eck, R. Gevers, N. van der Ven; Venlo: A. Duygun, B. Rahel, J. Meeder. Norway— Oslo: A. Vold, C. Holst Hansen, I. Engset, D. Atar. Poland— Bytom: B. Dyduch-Fejklowicz, E. Koba, M. Cichocka; Cieszyn: A. Sokal, A. Kubicius, E. Pruchniewicz; Gliwice: A. Kowalik-Sztylc, W. Czapla; Katowice: I. Mr{\'o}z, M. Kozlowski, T. Pawlowski, M. Tendera; Katowice: A. Winiarska-Filipek, A. Fidyk, A. Slowikowski, M. Haberka, M. Lachor-Broda, M. Biedron, Z. Gasior; Kielce: M. Ko{\l}odziej, M. Janion; Kielce: I. Gorczyca-Michta, B. Wozakowska-Kaplon; {\L}{\'o}d{\'z}: M. Stasiak, P. Jakubowski, T. Ciurus, J. Drozdz; {\L}{\'o}d{\'z}: M. Simiera, P. Zajac, T. Wcislo, P. Zycinski, J. Kasprzak; Nysa: A. Olejnik, E. Harc-Dyl, J. Miarka, M. Pasieka, M. Ziemi{\'n}ska-{\L}u{\'c}, W. Bujak; Opoczno: A. {\'S}liwi{\'n}ski, A. Grech, J. Morka, K. Petrykowska, M. Prasa{\l}; Opole: G. Hordy{\'n}ski, P. Feusette, P. Lipski, A. Wester; Radlin: W. Streb; Rzesz{\'o}w: J. Romanek, P. Wo{\'z}niak, M. Chlebu{\'s}, P. Szafarz, W. Stanik; Szczecin: M. Zakrzewski, J. Ka{\'z}mierczak; Szczecin: A. Przybylska, E. Skorek, H. B{\l}aszczyk, M. St{\c e}pie{\'n}, S. Szabowski, W. Krysiak, M. Szyma{\'n}ska; Tarn{\'o}w: J. Karasi{\'n}ski, J. Blicharz, M. Skura; Warsaw: K. Ha{\l}as, L. Michalczyk, Z. Orski, K. Krzy{\.z}anowski, A. Skrobowski; Warsaw: L. Zieli{\'n}ski, M. Tomaszewska-Kiecana, M. D{\l}u{\.z}niewski; Warsaw: M. Kiliszek, M. Peller, M. Budnik, P. Balsam, G. Opolski, A. Tymi{\'n}ska, K. Oziera{\'n}ski, A. Wancerz; Warsaw: A. Borowiec, E. Majos, R. Dabrowski, H. Szwed; Zabrze: A. Musialik-Lydka; Zabrze: A. Leopold-Jadczyk, E. Jedrzejczyk-Patej, M. Koziel, R. Lenarczyk, M. Mazurek, Z. Kalarus; Zabrze: K. Krzemien-Wolska, P. Starosta, E. Nowalany-Kozielska; Zakopane: A. Orzechowska, M. Szpot, M. Staszel. Portugal— Almada: S. Almeida, H. Pereira, L. Brand{\~a}o Alves, R. Miranda, L. Ribeiro; Carnaxide Lisboa: F. Costa, F. Morgado, P. Carmo, P. Galvao Santos, R. Bernardo, P. Adrag{\~a}o; Santar{\'e}m: G. Ferreira da Silva, M. Peres, M. Alves, M. Leal; Vila Real: A. Cordeiro, P. Magalh{\~a}es, P. Fontes, S. Le{\~a}o; Viseu: A. Delgado, A. Costa, B. Marmelo, B. Rodrigues, D. Moreira, J. Santos, L. Santos. Romania— Arad: A. Terchet, D. Darabantiu, S. Mercea, V. Turcin Halka, A. Pop Moldovan; Brasov: A. Gabor, B. Doka, G. Catanescu, H. Rus, L. Oboroceanu, E. Bobescu; Bucharest: R. Popescu, A. Dan, A. Buzea, I. Daha, G. Dan, I. Neuhoff; Bucharest: M. Baluta, R. Ploesteanu, N. Dumitrache, M. Vintila; Bucharest: A. Daraban, C. Japie, E. Badila, H. Tewelde, M. Hostiuc, S. Frunza, E. Tintea, D. Bartos; Bucharest: A. Ciobanu, I. Popescu, N. Toma, C. Gherghinescu, D. Cretu, N. Patrascu, C. Stoicescu, C. Udroiu, G. Bicescu, V. Vintila, D. Vinereanu, M. Cinteza, R. Rimbas; Iași: M. Grecu; Oradea: A. Cozma, F. Boros, M. Ille, O. Tica, R. Tor, A. Corina, A. Jeewooth, B. Maria, C. Georgiana, C. Natalia, D. Alin, D. Dinu-Andrei, M. Livia, R. Daniela, R. Larisa, S. Umaar, T. Tamara, M. Ioachim Popescu; T{\^a}rgu Mureș: D. Nistor, I. Sus, O. Coborosanu; Timișoara: N. Alina-Ramona, R. Dan, L. Petrescu; Timișoara: G. Ionescu, I. Popescu, C. Vacarescu, E. Goanta, M. Mangea, A. Ionac, C. Mornos, D. Cozma, S. Pescariu. Russian Federation— Arkhangelsk: E. Solodovnicova, I. Soldatova, J. Shutova, L. Tjuleneva, T. Zubova, V. Uskov; Arkhangelsk: D. Obukhov, G. Rusanova; Arkhangelsk: I. Soldatova, N. Isakova, S. Odinsova, T. Arhipova; Arkhangelsk: E. Kazakevich, E. Serdechnaya, O. Zavyalova; Saint-Petersburg: T. Novikova; Saint-Petersburg: I. Riabaia, S. Zhigalov; Saint-Petersburg: E. Drozdova, I. Luchkina, Y. Monogarova; Vladivostok: D. Hegya, L. Rodionova, L. Rodionova, V. Nevzorova; Vladivostok: I. Soldatova, O. Lusanova. Serbia— Belgrade: A. Arandjelovic, D. Toncev, M. Milanov, N. Sekularac; Belgrade: M. Zdravkovic, S. Hinic, S. Dimkovic, T. Acimovic, J. Saric; Belgrade: M. Polovina, T. Potpara, B. Vujisic-Tesic, M. Nedeljkovic; Belgrade: M. Zlatar, M. Asanin; Belgrade: V. Vasic, Z. Popovic; Belgrade: D. Djikic, M. Sipic, V. Peric, B. Dejanovic, N. Milosevic; Belgrade: A. Stevanovic, A. Andric, B. Pencic, M. Pavlovic-Kleut, V. Celic; Kragujevac: M. Pavlovic, M. Petrovic, M. Vuleta, N. Petrovic, S. Simovic, Z. Savovic, S. Milanov, G. Davidovic, V. Iric-Cupic; Ni{\v s}ka Banja: D. Simonovic, M. Stojanovic, S. Stojanovic, V. Mitic, V. Ilic, D. Petrovic, M. Deljanin Ilic, S. Ilic, V. Stoickov; Pirot: S. Markovic; {\v S}abac: S. Kovacevic. Spain— Alicante: A. Garc{\'i}a Fernandez; Benalmadena: A. Perez Cabeza; C{\'o}rdoba: M. Anguita; Elche, Alicante: A. Maestre; Toledo: S. Casta{\~n}o Granada: L. Tercedor Sanchez; Huarte: E. Mau, J. Loayssa, M. Ayarra, M. Carpintero; Madrid: I. Rold{\'a}n Rabadan; Murcia: M. Leal; Murcia: M. Gil Ortega; Murcia: A. Tello Montoliu, E. Orenes Pi{\~n}ero, S. Manzano Fern{\'a}ndez, F. Mar{\'i}n, A. Romero Aniorte, A. Veliz Mart{\'i}nez, M. Quintana Giner; Madrid: M. Ciudad; Pamplona: G. Ballesteros, M. Palacio, O. Alcalde, I. Garc{\'i}a-Bolao; San Juan de Alicante: V. Bertomeu Gonzalez; Santiago de Compostela: F. Otero-Ravi{\~n}a, J. Garc{\'i}a Seara, J. Gonzalez Juanatey. Switzerland— Geneva: N. Dayal, P. Maziarski, P. Gentil-Baron, D. Shah. Turkey— Adana: M. Ko{\c c}; Afyon: E. Onrat, I. E. Dural; Ankara: K. Yilmaz, B. {\"O}zin; Ankara: S. Tan Kurklu, Y. Atmaca; Ankara: U. Canpolat, L. Tokgozoglu; Ankara: A. K. Dolu, B. Demirtas, D. Sahin; Ankara: O. Ozcan Celebi, E. Diker; Antalya: G. Gagirci; Bayraklı/Izmir: U.O.Turk; Bursa: H. Ari; Diyarbakır: N. Polat, N. Toprak; Gaziantep: M. Sucu; G{\"o}r{\"u}kle-Bursa: O. Akin Serdar; Istanbul: A. Taha Alper; Istanbul: A. Kepez; Istanbul: Y. Yuksel; Kurupelit - Samsun: A. Uzunselvi, S. Yuksel, M. Sahin; Merkez/D{\"u}zce: O. Kayapinar; Mersin: T. Ozcan; Sivas: H. Kaya, M. B. Yilmaz; Trabzon: M. Kutlu; Y{\"u}reğir-Adana: M. Demir. UK— Barnstaple: C. Gibbs, S. Kaminskiene, M. Bryce, A. Skinner, G. Belcher, J. Hunt, L. Stancombe, B. Holbrook, C. Peters, S. Tettersell; Birmingham: A. Shantsila, D. Lane, K. Senoo, M. Proietti, K. Russell, P. Domingos, S. Hussain, J. Partridge, R. Haynes, S. Bahadur, R. Brown, S. McMahon, G. Y H Lip; Blackburn: J. McDonald, K. Balachandran, R. Singh, S. Garg, H. Desai, K. Davies, W. Goddard; Blackpool: G. Galasko, I. Rahman, Y. Chua, O. Payne, S. Preston, O. Brennan, L. Pedley, C. Whiteside, C. Dickinson, J. Brown, K. Jones, L. Benham, R. Brady; Carlisle: L. Buchanan, A. Ashton, H. Crowther, H. Fairlamb, S. Thornthwaite, C. Relph, A. McSkeane, U. Poultney, N. Kelsall, P. Rice, T. Wilson; Chertsey: M. Wrigley, R. Kaba, T. Patel, E. Young, J. Law; Cramlington: C. Runnett, H. Thomas, H. McKie, J. Fuller, S. Pick; Exeter: A. Sharp, A. Hunt, K. Thorpe, C. Hardman, E. Cusack, L. Adams, M. Hough, S. Keenan, A. Bowring, J. Watts; Great Yarmouth: J. Zaman, K. Goffin, H. Nutt; Harrogate: Y. Beerachee, J. Featherstone, C. Mills, J. Pearson, L. Stephenson; Huddersfield: S. Grant, A. Wilson, C. Hawksworth, I. Alam, M. Robinson, S. Ryan; Macclesfield: R. Egdell, E. Gibson, M. Holland, D. Leonard; Maidstone: B. Mishra, S. Ahmad, H. Randall, J. Hill, L. Reid, M. George, S. McKinley, L. Brockway, W. Milligan; Manchester: J. Sobolewska, J. Muir, L. Tuckis, L. Winstanley, P. Jacob, S. Kaye, L. Morby; Nottingham: A. Jan, T. Sewell; Poole: C. Boos, B. Wadams, C. Cope, P. Jefferey; Portsmouth: N. Andrews, A. Getty, A. Suttling, C. Turner, K. Hudson, R. Austin, S. Howe; Redhill: R. Iqbal, N. Gandhi, K. Brophy, P. Mirza, E. Willard, S. Collins, N. Ndlovu; Rhyl: E. Subkovas, V. Karthikeyan, L. Waggett, A. Wood, A. Bolger, J. Stockport, L. Evans, E. Harman, J. Starling, L. Williams, V. Saul; Salisbury: M. Sinha, L. Bell, S. Tudgay, S. Kemp, J. Brown, L. Frost; Shrewsbury: T. Ingram, A. Loughlin, C. Adams, M. Adams, F. Hurford, C. Owen, C. Miller, D. Donaldson, H. Tivenan, H. Button; South Shields: A. Nasser, O. Jhagra, B. Stidolph, C. Brown, C. Livingstone, M. Duffy, P. Madgwick; Southampton: P. Roberts, E. Greenwood, L. Fletcher, M. Beveridge, S. Earles; Taunton: D. McKenzie, D. Beacock, M. Dayer, M. Seddon, D. Greenwell, F. Luxton, F. Venn, H. Mills, J. Rewbury, K. James, K. Roberts, L. Tonks; Torquay: D. Felmeden, W. Taggu, A. Summerhayes, D. Hughes, J. Sutton, L. Felmeden; Watford: M. Khan, E. Walker, L. Norris, L. O'Donohoe; Weston-super-Mare: A. Mozid, H. Dymond, H. Lloyd-Jones, G. Saunders, D. Simmons, D. Coles, D. Cotterill, S. Beech, S. Kidd; Wolverhampton: B. Wrigley, S. Petkar, A. Smallwood, R. Jones, E. Radford, S. Milgate, S. Metherell, V. Cottam; Yeovil: C. Buckley, A. Broadley, D. Wood, J. Allison, K. Rennie, L. Balian, L. Howard, L. Pippard, S. Board, T. Pitt-Kerby. Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = dec,
day = "1",
doi = "10.1186/s12916-022-02526-7",
language = "English",
volume = "20",
journal = "BMC medicine",
issn = "1741-7015",
publisher = "BioMed Central",
number = "1",

}

RIS

TY - JOUR

T1 - Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation

T2 - a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

AU - Romiti, Giulio Francesco

AU - Proietti, Marco

AU - Vitolo, Marco

AU - Bonini, Niccolò

AU - Fawzy, Ameenathul Mazaya

AU - Ding, Wern Yew

AU - Fauchier, Laurent

AU - Marin, Francisco

AU - Nabauer, Michael

AU - Dan, Gheorghe Andrei

AU - Potpara, Tatjana S.

AU - Boriani, Giuseppe

AU - Lip, Gregory Y. H.

AU - on behalf of the ESC-EHRA EORP-AF General Long-Term Registry Investigators

AU - Tavazzi, L.

AU - Maggioni, A. P.

AU - Kalarus, Z.

AU - Ferrari, R.

AU - Shantsila, A.

AU - Goda, A.

AU - Mairesse, G.

AU - Shalganov, T.

AU - Antoniades, L.

AU - Taborsky, M.

AU - Riahi, S.

AU - Muda, P.

AU - García Bolao, I.

AU - Piot, O.

AU - Etsadashvili, K.

AU - Simantirakis, E. N.

AU - Haim, M.

AU - Azhari, A.

AU - Najafian, J.

AU - Santini, M.

AU - Mirrakhimov, E.

AU - Kulzida, K.

AU - Erglis, A.

AU - Poposka, L.

AU - Burg, M. R.

AU - Crijns, H.

AU - Erküner, null

AU - Atar, D.

AU - Lenarczyk, R.

AU - Oliveira, M. Martins

AU - Shah, D.

AU - Serdechnaya, E.

AU - Diker, E.

AU - Lane, D.

AU - Zëra, E.

AU - Ekmekçiu, U.

AU - Paparisto, V.

AU - Tase, M.

AU - Gjergo, H.

AU - Dragoti, J.

AU - Goda, A.

AU - Ciutea, M.

AU - Ahadi, N.

AU - el Husseini, Z.

AU - Raepers, M.

AU - Leroy, J.

AU - Haushan, P.

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N1 - Funding Information: MP is an investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 899871. LF has been a consultant and speaker for AstraZeneca, Bayer, BMS/Pfizer, Boehringer Ingelheim, Medtronic, Novartis, Novo, XO and Zoll. FM is a consultant for Bayer and Boehringer-Ingelheim; FM received small research’s fees from AFNET, Ferrer, Astra-Zeneca, Boehringer-Ingelheim and Bayer; FM is an investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 899871. TSP is a consultant for Bayer and Pfizer, with no fees received personally; GB a received small speaker’s fees from Medtronic, Boston, Boehringer Ingelheim and Bayer; GYHL is a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim and Daiichi-Sankyo. No fees are received personally. GYHL is co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 899871. Funding Information: EORP Oversight Committee, Executive and Steering Committees (National Coordinators) of the EURObservational Research Programme (EORP)—Atrial Fibrillation General Long-Term (EORP-AFGen LT) Registry of the European Society of Cardiology (ESC). Data collection was conducted by the EORP department by Patti-Ann McNeill as Project Officer and Viviane Missiamenou as Data Manager. Overall activities were coordinated and supervised by Doctor Aldo P. Maggioni (EORP Scientific Coordinator). EURObservational Research Programme Atrial Fibrillation (EORP-AF) Long-Term General Registry Investigators Executive committee : G. Boriani (Chair), G.Y.H. Lip, L. Tavazzi, A. P. Maggioni, G-A. Dan, T. Potpara, M. Nabauer, F. Marin, Z. Kalarus, L. Fauchier, R. Ferrari, A. Shantsila. Steering Committee (National Coordinators) : A. Goda, University Hospital Center ‘Mother Tereza’, Tirana, Albania ; G. Mairesse, Cliniques du Sud-Luxembourg, Arlon, Belgium; T. Shalganov, National Heart Hospital, Sofia, Bulgaria; L. Antoniades, Nicosia General Hospital, Latsia, Cyprus; M. Taborsky, University Hospital Olomouc, Olomouc, Czech Republic; S. Riahi, Aalborg University Hospital, Aalborg, Denmark; P. Muda, University of Tartu, Tartu, Estonia; I. García Bolao, Navarra Institute for Health Research, Pamplona, Spain; O. Piot, Centre Cardiologique du Nord, Saint-Denis, France; M. Nabauer, Ludwig-Maximilians-University, Munich, Germany; K. Etsadashvili, G. Chapidze Emergency Cardiology Center, Tbilisi, Georgia; EN. Simantirakis, University Hospital of Heraklion, School of Medicine, University of Crete, Heraklion, Crete, Greece; M. Haim, Soroka Medical Center, Beer Sheva, Israel; A. Azhari, J. Najafian, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; M. Santini, San Filippo Neri Hospital, Rome, Italy; E. Mirrakhimov, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan; K. Kulzida, Scientific-Research Institute of Cardiology and Internal Diseases, Almaty, Republic of Kazakhstan; A. Erglis, Pauls Stradins Clinical University Hospital University of Latvia Riga Latvia; L. Poposka, University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia; MR. Burg, Mater Dei Hospital, Triq Dun Karm Psaila, Malta; H. Crijns, Ö. Erküner, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands; D. Atar, Oslo University Hospital Ullevål and Institute of Clinical Sciences, University of Oslo, Oslo, Norway; R. Lenarczyk, Silesian Center for Heart Disease, Zabrze, Poland; M. Martins Oliveira, Hospital Santa Marta, Lisbon, Portugal; D. Shah, Department of Medicine Specialities, University Hospital Geneva, Geneva, Switzerland; G-A. Dan, Colentina University Hospital, Bucharest, Romania; E. Serdechnaya, Northern State Medical University, Arkhangelsk, Russia; T. Potpara, Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia; E. Diker, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey; G.Y.H. Lip, D. Lane; City Hospital, University of Birmingham, Birmingham, United Kingdom. Investigators : Albania —Durrës: E. Zëra; Tirana: U. Ekmekçiu, V. Paparisto, M. Tase; Tirana: H. Gjergo, J. Dragoti, A. Goda. Belgium— Bastogne: M. Ciutea, N. Ahadi, Z. el Husseini, M. Raepers; Gilly: J. Leroy, P. Haushan, A. Jourdan; Haine Saint Paul: C. Lepiece; Hasselt: L. Desteghe, J. Vijgen, P. Koopman, G. Van Genechten, H. Heidbuchel; Kortrijk: T. Boussy, M. De Coninck, H. Van Eeckhoutte, N. Bouckaert; La Louviere: A. Friart, J. Boreux, C. Arend; Liege: P. Evrard; Liège: L. Stefan, E. Hoffer, J. Herzet, M. Massoz; Liège: C. Celentano, M. Sprynger, L. Pierard; Liège: P. Melon; Overpelt: B. Van Hauwaert, C. Kuppens, D. Faes, D. Van Lier, A. Van Dorpe; Waremme: A. Gerardy; Yvoir: O. Deceuninck, O. Xhaet, F. Dormal, E. Ballant, D. Blommaert. Bulgaria— Pleven: D. Yakova, M. Hristov, T. Yncheva, N. Stancheva, S. Tisheva; Plovdiv: M. Tokmakova, F. Nikolov, D. Gencheva; Sofia: T. Shalganov, B. Kunev, M. Stoyanov; Sofia: D. Marchov, V. Gelev, V. Traykov; Varna: A. Kisheva, H. Tsvyatkov, R. Shtereva, S. Bakalska-Georgieva, S. Slavcheva, Y. Yotov. Czech Republic— Ústí nad Labem: M. Kubíčková. Denmark— Aalborg: A. Marni Joensen, A. Gammelmark, L. Hvilsted Rasmussen, P. Dinesen, S. Riahi, S. Krogh Venø, B. Sorensen, A. Korsgaard, K. Andersen, C. Fragtrup Hellum; Esbjerg: A. Svenningsen, O. Nyvad, P. Wiggers; Herning: O. May, A. Aarup, B. Graversen, L. Jensen, M. Andersen, M. Svejgaard, S. Vester, S. Hansen, V. Lynggaard. Estonia— Tallinn: R. Vettus; Tartu: P. Muda. Elche, Alicante: A. Maestre; Toledo: S. Castaño. France— Abbeville: S. Cheggour; Abbeville: J. Poulard, V. Mouquet, S. Leparrée; Aix-en-Provence: J. Bouet, J. Taieb; Amiens: A. Doucy, H. Duquenne; Angers: A. Furber, J. Dupuis, J. Rautureau; Aurillac: M. Font, P. Damiano; Avignon Cedex: M. Lacrimini; Brest: J. Abalea, S. Boismal, T. Menez, J. Mansourati; Chartres: G. Range, H. Gorka, C. Laure, C. Vassalière; Creteil: N. Elbaz, N. Lellouche, K. Djouadi; Montpellier: F. Roubille, D. Dietz, J. Davy; Nimes: M. Granier, P. Winum, C. Leperchois-Jacquey; Paris: H. Kassim, E. Marijon, J. Le Heuzey; Paris: J. Fedida, C. Maupain, C. Himbert, E. Gandjbakhch, F. Hidden-Lucet, G. Duthoit, N. Badenco, T. Chastre, X. Waintraub, M. Oudihat, J. Lacoste, C. Stephan; Pau: H. Bader, N. Delarche, L. Giry; Pessac: D. Arnaud, C. Lopez, F. Boury, I. Brunello, M. Lefèvre, R. Mingam, M. Haissaguerre; Rennes: M. Le Bidan, D. Pavin, V. Le Moal, C. Leclercq; Saint Denis: O. Piot, T. Beitar; Saint Etienne: I. Martel, A. Schmid, N. Sadki, C. Romeyer-Bouchard, A. Da Costa; Tours: I. Arnault, M. Boyer, C. Piat, L. Fauchier. FYR Macedonia —Bitola: N. Lozance, S. Nastevska; Ohrid: A. Doneva, B. Fortomaroska Milevska, B. Sheshoski, K. Petroska, N. Taneska, N. Bakrecheski; Skopje: K. Lazarovska, S. Jovevska, V. Ristovski, A. Antovski; Skopje: E. Lazarova, I. Kotlar, J. Taleski, L. Poposka, S. Kedev; Skopje: N. Zlatanovik; Štip: S. Jordanova, T. Bajraktarova Proseva, S. Doncovska. Georgia— Tbilisi: D. Maisuradze, A. Esakia, E. Sagirashvili, K. Lartsuliani, N. Natelashvili, N. Gumberidze, R. Gvenetadze; Tbilisi: K. Etsadashvili, N. Gotonelia, N. Kuridze; Tbilisi: G. Papiashvili, I. Menabde. Germany— Aachen: S. Glöggler, A. Napp, C. Lebherz, H. Romero, K. Schmitz, M. Berger, M. Zink, S. Köster, J. Sachse, E. Vonderhagen, G. Soiron, K. Mischke; Bad Reichenhall: R. Reith, M. Schneider; Berlin: W. Rieker; Biberach: D. Boscher, A. Taschareck, A. Beer; Boppard: D. Oster; Brandenburg: O. Ritter, J. Adamczewski, S. Walter; Chemnitz: A. Frommhold, E. Luckner, J. Richter, M. Schellner, S. Landgraf, S. Bartholome; Chemnitz: R. Naumann, J. Schoeler; Dachau: D. Westermeier, F. William, K. Wilhelm, M. Maerkl; Detmold: R. Oekinghaus, M. Denart, M. Kriete, U. Tebbe; Ebersbach: T. Scheibner; Erlangen: M. Gruber, A. Gerlach, C. Beckendorf, L. Anneken, M. Arnold, S. Lengerer, Z. Bal, C. Uecker, H. Förtsch, S. Fechner, V. Mages; Friedberg: E. Martens, H. Methe; Göttingen: T. Schmidt; Hamburg: B. Schaeffer, B. Hoffmann, J. Moser, K. Heitmann, S. Willems, S. Willems; Hartmannsdorf: C. Klaus, I. Lange; Heidelberg: M. Durak, E. Esen; Itzehoe: F. Mibach, H. Mibach; Kassel: A. Utech; Kirchzarten: M. Gabelmann, R. Stumm, V. Ländle; Koblenz: C. Gartner, C. Goerg, N. Kaul, S. Messer, D. Burkhardt, C. Sander, R. Orthen, S. Kaes; Köln: A. Baumer, F. Dodos; Königsbrück: A. Barth, G. Schaeffer; Leisnig: J. Gaertner, J. Winkler; Leverkusen: A. Fahrig, J. Aring, I. Wenzel; Limburg: S. Steiner, A. Kliesch, E. Kratz, K. Winter, P. Schneider; Ludwigsburg: A. Haag, I. Mutscher, R. Bosch; Markkleeberg: J. Taggeselle, S. Meixner; Meissen: A. Schnabel; Meppen: A. Shamalla, H. Hötz, A. Korinth; Merzig: C. Rheinert; Moosburg: G. Mehltretter; Mühldorf: B. Schön, N. Schön, A. Starflinger, E. Englmann; Munich: G. Baytok, T. Laschinger, G. Ritscher; Munich: A. Gerth; Münster: D. Dechering, L. Eckardt; Nienburg: M. Kuhlmann, N. Proskynitopoulos; Paderborn: J. Brunn, K. Foth; Pirna: C. Axthelm, H. Hohensee, K. Eberhard, S. Turbanisch; Plauen: N. Hassler, A. Koestler; Riesa: G. Stenzel; Riesa: D. Kschiwan, M. Schwefer, S. Neiner, S. Hettwer; Rotenburg a.d. Fulda: M. Haeussler-Schuchardt, R. Degenhardt, S. Sennhenn, S. Steiner; Starnberg: M. Brendel; Westerstede: A. Stoehr, W. Widjaja, S. Loehndorf, A. Logemann, J. Hoskamp, J. Grundt; Zorneding: M. Block; Zwiesel: R. Ulrych, A. Reithmeier, V. Panagopoulos. Italy— Bologna: C. Martignani, D. Bernucci, E. Fantecchi, I. Diemberger, M. Ziacchi, M. Biffi, P. Cimaglia, J. Frisoni, G. Boriani; Firenze: I. Giannini, S. Boni, S. Fumagalli, S. Pupo, A. Di Chiara, P. Mirone; Modena: E. Fantecchi, G. Boriani, F. Pesce, C. Zoccali, V.L. Malavasi. Kazakhstan— Almaty: A. Mussagaliyeva, B. Ahyt, Z. Salihova, K. Koshum-Bayeva. Kyrgyzstan— Bishkek: A. Kerimkulova, A. Bairamukova, E. Mirrakhimov. Latvia— Riga: B. Lurina, R. Zuzans, S. Jegere, I. Mintale, K. Kupics, K. Jubele, A. Erglis, O. Kalejs. Malta— Birkirkara: K. Vanhear, M. Burg, M. Cachia, E. Abela, S. Warwicker, T. Tabone, R. Xuereb. Montenegro— Podgorica: D. Asanovic, D. Drakalovic, M. Vukmirovic, N. Pavlovic, L. Music, N. Bulatovic, A. Boskovic. Netherlands— Almere: H. Uiterwaal, N. Bijsterveld; Amsterdam: J. De Groot, J. Neefs, N. van den Berg, F. Piersma, A. Wilde; Delfzijl: V. Hagens; Enschede: J. Van Es, J. Van Opstal, B. Van Rennes, H. Verheij, W. Breukers; Heerenveen: G. Tjeerdsma, R. Nijmeijer, D. Wegink, R. Binnema; Hengelo: S. Said; Maastricht: Ö. Erküner, S. Philippens, W. van Doorn, H. Crijns; Rotterdam: T. Szili-Torok, R. Bhagwandien, P. Janse, A. Muskens; s-Hertogenbosch: M. van Eck, R. Gevers, N. van der Ven; Venlo: A. Duygun, B. Rahel, J. Meeder. Norway— Oslo: A. Vold, C. Holst Hansen, I. Engset, D. Atar. Poland— Bytom: B. Dyduch-Fejklowicz, E. Koba, M. Cichocka; Cieszyn: A. Sokal, A. Kubicius, E. Pruchniewicz; Gliwice: A. Kowalik-Sztylc, W. Czapla; Katowice: I. Mróz, M. Kozlowski, T. Pawlowski, M. Tendera; Katowice: A. Winiarska-Filipek, A. Fidyk, A. Slowikowski, M. Haberka, M. Lachor-Broda, M. Biedron, Z. Gasior; Kielce: M. Kołodziej, M. Janion; Kielce: I. Gorczyca-Michta, B. Wozakowska-Kaplon; Łódź: M. Stasiak, P. Jakubowski, T. Ciurus, J. Drozdz; Łódź: M. Simiera, P. Zajac, T. Wcislo, P. Zycinski, J. Kasprzak; Nysa: A. Olejnik, E. Harc-Dyl, J. Miarka, M. Pasieka, M. Ziemińska-Łuć, W. Bujak; Opoczno: A. Śliwiński, A. Grech, J. Morka, K. Petrykowska, M. Prasał; Opole: G. Hordyński, P. Feusette, P. Lipski, A. Wester; Radlin: W. Streb; Rzeszów: J. Romanek, P. Woźniak, M. Chlebuś, P. Szafarz, W. Stanik; Szczecin: M. Zakrzewski, J. Kaźmierczak; Szczecin: A. Przybylska, E. Skorek, H. Błaszczyk, M. Stępień, S. Szabowski, W. Krysiak, M. Szymańska; Tarnów: J. Karasiński, J. Blicharz, M. Skura; Warsaw: K. Hałas, L. Michalczyk, Z. Orski, K. Krzyżanowski, A. Skrobowski; Warsaw: L. Zieliński, M. Tomaszewska-Kiecana, M. Dłużniewski; Warsaw: M. Kiliszek, M. Peller, M. Budnik, P. Balsam, G. Opolski, A. Tymińska, K. Ozierański, A. Wancerz; Warsaw: A. Borowiec, E. Majos, R. Dabrowski, H. Szwed; Zabrze: A. Musialik-Lydka; Zabrze: A. Leopold-Jadczyk, E. Jedrzejczyk-Patej, M. Koziel, R. Lenarczyk, M. Mazurek, Z. Kalarus; Zabrze: K. Krzemien-Wolska, P. Starosta, E. Nowalany-Kozielska; Zakopane: A. Orzechowska, M. Szpot, M. Staszel. Portugal— Almada: S. Almeida, H. Pereira, L. Brandão Alves, R. Miranda, L. Ribeiro; Carnaxide Lisboa: F. Costa, F. Morgado, P. Carmo, P. Galvao Santos, R. Bernardo, P. Adragão; Santarém: G. Ferreira da Silva, M. Peres, M. Alves, M. Leal; Vila Real: A. Cordeiro, P. Magalhães, P. Fontes, S. Leão; Viseu: A. Delgado, A. Costa, B. Marmelo, B. Rodrigues, D. Moreira, J. Santos, L. Santos. Romania— Arad: A. Terchet, D. Darabantiu, S. Mercea, V. Turcin Halka, A. Pop Moldovan; Brasov: A. Gabor, B. Doka, G. Catanescu, H. Rus, L. Oboroceanu, E. Bobescu; Bucharest: R. Popescu, A. Dan, A. Buzea, I. Daha, G. Dan, I. Neuhoff; Bucharest: M. Baluta, R. Ploesteanu, N. Dumitrache, M. Vintila; Bucharest: A. Daraban, C. Japie, E. Badila, H. Tewelde, M. Hostiuc, S. Frunza, E. Tintea, D. Bartos; Bucharest: A. Ciobanu, I. Popescu, N. Toma, C. Gherghinescu, D. Cretu, N. Patrascu, C. Stoicescu, C. Udroiu, G. Bicescu, V. Vintila, D. Vinereanu, M. Cinteza, R. Rimbas; Iași: M. Grecu; Oradea: A. Cozma, F. Boros, M. Ille, O. Tica, R. Tor, A. Corina, A. Jeewooth, B. Maria, C. Georgiana, C. Natalia, D. Alin, D. Dinu-Andrei, M. Livia, R. Daniela, R. Larisa, S. Umaar, T. Tamara, M. Ioachim Popescu; Târgu Mureș: D. Nistor, I. Sus, O. Coborosanu; Timișoara: N. Alina-Ramona, R. Dan, L. Petrescu; Timișoara: G. Ionescu, I. Popescu, C. Vacarescu, E. Goanta, M. Mangea, A. Ionac, C. Mornos, D. Cozma, S. Pescariu. Russian Federation— Arkhangelsk: E. Solodovnicova, I. Soldatova, J. Shutova, L. Tjuleneva, T. Zubova, V. Uskov; Arkhangelsk: D. Obukhov, G. Rusanova; Arkhangelsk: I. Soldatova, N. Isakova, S. Odinsova, T. Arhipova; Arkhangelsk: E. Kazakevich, E. Serdechnaya, O. Zavyalova; Saint-Petersburg: T. Novikova; Saint-Petersburg: I. Riabaia, S. Zhigalov; Saint-Petersburg: E. Drozdova, I. Luchkina, Y. Monogarova; Vladivostok: D. Hegya, L. Rodionova, L. Rodionova, V. Nevzorova; Vladivostok: I. Soldatova, O. Lusanova. Serbia— Belgrade: A. Arandjelovic, D. Toncev, M. Milanov, N. Sekularac; Belgrade: M. Zdravkovic, S. Hinic, S. Dimkovic, T. Acimovic, J. Saric; Belgrade: M. Polovina, T. Potpara, B. Vujisic-Tesic, M. Nedeljkovic; Belgrade: M. Zlatar, M. Asanin; Belgrade: V. Vasic, Z. Popovic; Belgrade: D. Djikic, M. Sipic, V. Peric, B. Dejanovic, N. Milosevic; Belgrade: A. Stevanovic, A. Andric, B. Pencic, M. Pavlovic-Kleut, V. Celic; Kragujevac: M. Pavlovic, M. Petrovic, M. Vuleta, N. Petrovic, S. Simovic, Z. Savovic, S. Milanov, G. Davidovic, V. Iric-Cupic; Niška Banja: D. Simonovic, M. Stojanovic, S. Stojanovic, V. Mitic, V. Ilic, D. Petrovic, M. Deljanin Ilic, S. Ilic, V. Stoickov; Pirot: S. Markovic; Šabac: S. Kovacevic. Spain— Alicante: A. García Fernandez; Benalmadena: A. Perez Cabeza; Córdoba: M. Anguita; Elche, Alicante: A. Maestre; Toledo: S. Castaño Granada: L. Tercedor Sanchez; Huarte: E. Mau, J. Loayssa, M. Ayarra, M. Carpintero; Madrid: I. Roldán Rabadan; Murcia: M. Leal; Murcia: M. Gil Ortega; Murcia: A. Tello Montoliu, E. Orenes Piñero, S. Manzano Fernández, F. Marín, A. Romero Aniorte, A. Veliz Martínez, M. Quintana Giner; Madrid: M. Ciudad; Pamplona: G. Ballesteros, M. Palacio, O. Alcalde, I. García-Bolao; San Juan de Alicante: V. Bertomeu Gonzalez; Santiago de Compostela: F. Otero-Raviña, J. García Seara, J. Gonzalez Juanatey. Switzerland— Geneva: N. Dayal, P. Maziarski, P. Gentil-Baron, D. Shah. Turkey— Adana: M. Koç; Afyon: E. Onrat, I. E. Dural; Ankara: K. Yilmaz, B. Özin; Ankara: S. Tan Kurklu, Y. Atmaca; Ankara: U. Canpolat, L. Tokgozoglu; Ankara: A. K. Dolu, B. Demirtas, D. Sahin; Ankara: O. Ozcan Celebi, E. Diker; Antalya: G. Gagirci; Bayraklı/Izmir: U.O.Turk; Bursa: H. Ari; Diyarbakır: N. Polat, N. Toprak; Gaziantep: M. Sucu; Görükle-Bursa: O. Akin Serdar; Istanbul: A. Taha Alper; Istanbul: A. Kepez; Istanbul: Y. Yuksel; Kurupelit - Samsun: A. Uzunselvi, S. Yuksel, M. Sahin; Merkez/Düzce: O. Kayapinar; Mersin: T. Ozcan; Sivas: H. Kaya, M. B. Yilmaz; Trabzon: M. Kutlu; Yüreğir-Adana: M. Demir. UK— Barnstaple: C. Gibbs, S. Kaminskiene, M. Bryce, A. Skinner, G. Belcher, J. Hunt, L. Stancombe, B. Holbrook, C. Peters, S. Tettersell; Birmingham: A. Shantsila, D. Lane, K. Senoo, M. Proietti, K. Russell, P. Domingos, S. Hussain, J. Partridge, R. Haynes, S. Bahadur, R. Brown, S. McMahon, G. Y H Lip; Blackburn: J. McDonald, K. Balachandran, R. Singh, S. Garg, H. Desai, K. Davies, W. Goddard; Blackpool: G. Galasko, I. Rahman, Y. Chua, O. Payne, S. Preston, O. Brennan, L. Pedley, C. Whiteside, C. Dickinson, J. Brown, K. Jones, L. Benham, R. Brady; Carlisle: L. Buchanan, A. Ashton, H. Crowther, H. Fairlamb, S. Thornthwaite, C. Relph, A. McSkeane, U. Poultney, N. Kelsall, P. Rice, T. Wilson; Chertsey: M. Wrigley, R. Kaba, T. Patel, E. Young, J. Law; Cramlington: C. Runnett, H. Thomas, H. McKie, J. Fuller, S. Pick; Exeter: A. Sharp, A. Hunt, K. Thorpe, C. Hardman, E. Cusack, L. Adams, M. Hough, S. Keenan, A. Bowring, J. Watts; Great Yarmouth: J. Zaman, K. Goffin, H. Nutt; Harrogate: Y. Beerachee, J. Featherstone, C. Mills, J. Pearson, L. Stephenson; Huddersfield: S. Grant, A. Wilson, C. Hawksworth, I. Alam, M. Robinson, S. Ryan; Macclesfield: R. Egdell, E. Gibson, M. Holland, D. Leonard; Maidstone: B. Mishra, S. Ahmad, H. Randall, J. Hill, L. Reid, M. George, S. McKinley, L. Brockway, W. Milligan; Manchester: J. Sobolewska, J. Muir, L. Tuckis, L. Winstanley, P. Jacob, S. Kaye, L. Morby; Nottingham: A. Jan, T. Sewell; Poole: C. Boos, B. Wadams, C. Cope, P. Jefferey; Portsmouth: N. Andrews, A. Getty, A. Suttling, C. Turner, K. Hudson, R. Austin, S. Howe; Redhill: R. Iqbal, N. Gandhi, K. Brophy, P. Mirza, E. Willard, S. Collins, N. Ndlovu; Rhyl: E. Subkovas, V. Karthikeyan, L. Waggett, A. Wood, A. Bolger, J. Stockport, L. Evans, E. Harman, J. Starling, L. Williams, V. Saul; Salisbury: M. Sinha, L. Bell, S. Tudgay, S. Kemp, J. Brown, L. Frost; Shrewsbury: T. Ingram, A. Loughlin, C. Adams, M. Adams, F. Hurford, C. Owen, C. Miller, D. Donaldson, H. Tivenan, H. Button; South Shields: A. Nasser, O. Jhagra, B. Stidolph, C. Brown, C. Livingstone, M. Duffy, P. Madgwick; Southampton: P. Roberts, E. Greenwood, L. Fletcher, M. Beveridge, S. Earles; Taunton: D. McKenzie, D. Beacock, M. Dayer, M. Seddon, D. Greenwell, F. Luxton, F. Venn, H. Mills, J. Rewbury, K. James, K. Roberts, L. Tonks; Torquay: D. Felmeden, W. Taggu, A. Summerhayes, D. Hughes, J. Sutton, L. Felmeden; Watford: M. Khan, E. Walker, L. Norris, L. O'Donohoe; Weston-super-Mare: A. Mozid, H. Dymond, H. Lloyd-Jones, G. Saunders, D. Simmons, D. Coles, D. Cotterill, S. Beech, S. Kidd; Wolverhampton: B. Wrigley, S. Petkar, A. Smallwood, R. Jones, E. Radford, S. Milgate, S. Metherell, V. Cottam; Yeovil: C. Buckley, A. Broadley, D. Wood, J. Allison, K. Rennie, L. Balian, L. Howard, L. Pippard, S. Board, T. Pitt-Kerby. Publisher Copyright: © 2022, The Author(s).

PY - 2022/12/1

Y1 - 2022/12/1

N2 - Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients.

AB - Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients.

KW - Atrial fibrillation

KW - Clinical complexity

KW - Integrated management

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=85137159301&partnerID=8YFLogxK

U2 - 10.1186/s12916-022-02526-7

DO - 10.1186/s12916-022-02526-7

M3 - Article

C2 - 36056426

VL - 20

JO - BMC medicine

JF - BMC medicine

SN - 1741-7015

IS - 1

M1 - 326

ER -

ID: 26192795