Lee Geraldine A, Farkowski Michał M, Baker Edward, Sterliński Maciej, van Gelder Isabelle C, Dąbrowski Rafal, Desteghe Lien, Szumowski Łukasz, Merino Jose L, Collins Ronan, Rienstra Michiel, Heidbuchel Hein
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
Department of Cardiology, Ministry of Interior and Administration National Medical Institute, Warszawa, Poland.
Kardiol Pol. 2023;81(6):580-586. doi: 10.33963/KP.a2023.0069. Epub 2023 Mar 16.
Atrial fibrillation (AF) is the most common arrhythmia which places a significant bur-den on individuals as well as the healthcare system. AF management requires a multidisciplinary approach in which tackling comorbidities is an important aspect.
This study aimed to evaluate how multimorbidity is currently assessed and managed and to determine if interdisciplinary care is undertaken.
A 21-item online survey was undertaken over four weeks as part of the EHRA-PATHS study examining comorbidities in AF and distributed to European Heart Rhythm Association members in Europe.
A total of 341 eligible responses were received, of which 35 (10%) were from Polish physi-cians. Compared to other European locations, the rates of specialist services and referrals varied but were not significantly different. However, there were higher numbers of specialized services reported in Poland compared to the rest of Europe for hypertension (57% vs. 37%; P = 0.02) and palpita-tions/arrhythmias (63% vs. 41%; P = 0.01), whereas rates of sleep apnea services and comprehensive geriatric care tended to be lower (20% vs. 34%; P = 0.10 and 14% vs. 36%; P = 0.01, respectively). The only statistical difference in reasons for referral rates between Poland and the rest of Europe was the barrier relating to insurance and financial reasons (31% vs. 11%; P <0.01, respectively).
There is a clear need for an integrated approach to patients with AF and associated comorbidities. Preparedness of Polish physicians to deliver such care seems to be similar to other European countries but may be hampered by financial obstacles.
心房颤动（AF）是最常见的心律失常，给个人以及医疗保健系统带来了沉重负担。房颤的管理需要多学科方法，其中应对合并症是一个重要方面。
本研究旨在评估目前如何评估和管理多种合并症，并确定是否开展了跨学科护理。
作为EHRA-PATHS研究的一部分，在四周内进行了一项包含21个项目的在线调查，该研究调查房颤合并症，并分发给欧洲的欧洲心律协会成员。
共收到341份合格回复，其中35份（10%）来自波兰医生。与欧洲其他地区相比，专科服务和转诊率有所不同，但差异不显著。然而，与欧洲其他地区相比，波兰报告的高血压专科服务数量更多（57%对37%；P = 0.02），心悸/心律失常专科服务数量更多（63%对41%；P = 0.01），而睡眠呼吸暂停服务和综合老年护理的比例往往较低（分别为20%对34%；P = 0.10和14%对36%；P = 0.01）。波兰与欧洲其他地区转诊率原因的唯一统计差异是与保险和财务原因相关的障碍（分别为31%对11%；P <0.01）。
对于房颤及相关合并症患者，显然需要一种综合方法。波兰医生提供此类护理的准备情况似乎与其他欧洲国家相似，但可能受到财务障碍的阻碍。
