ISSN: 1885-5857 Impact factor 2023 7.2
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Original article
The European Society of Cardiology quality indicators in atrial fibrillation in centers of excellence in Spain: the SEC-EXCELENTE FA registry

Los indicadores de calidad de la Sociedad Europea de Cardiología en fibrilación auricular en centros de excelencia en España: el registro SEC-EXCELENTE FA

Martín Ruiz OrtizabcElena Arbello LaínezdInmaculada Roldán RabadáneFrancisco MarínbfAlejandro Pérez CabezabgRaquel Marzoa RivashRafael Peinado PeinadoeAlmudena Valle AlbercaiAlicia Ibáñez CriadojAlfonso Valle MuñozkJoaquín Osca AsensilAna del Río LechugamFrancisco Javier Elola SomozanManuel Anguita Sánchezab on behalf of the investigators of the SEC- EXCELENTE FA registry Martín Ruiz OrtizoRafael Peinado PeinadopElena Arbelo LaínezqAlmudena Valle AlbercarAlicia Ibáñez CriadosAlfonso Valle MuñoztJoaquín Osca AsensiuAna Del Río LechugavAlejandro I. Pérez Cabezaw
https://doi.org/10.1016/j.rec.2024.08.007
La versión en español de este artículo estará disponible en breve
Imagen extra
10.1016/j.rec.2024.08.007
Abstract
Introduction and objectives

By 2022, 9 centers had been accredited by the Spanish Society of Cardiology for the atrial fibrillation (AF) process. Our objective was to evaluate the performance of these centers based on the quality indicators (QIs) proposed by the European Society of Cardiology (ESC) in 2020.

Methods

Adults with AF who were attended in the cardiology departments of participating centers during the second week of May 2019 were included in a retrospective registry (n=797, age 72±11 years, 60% male). Key ESC QIs were assessed.

Results

CHA2DS2-VASc, HAS-BLED scores, and serum creatinine levels were documented in 24.9%, 6.1%, and 96.2% of patients, respectively. Anticoagulation was appropriately prescribed in 90.6% of high-risk patients according to the CHA2DS2-VASc score, but was inappropriately prescribed in 57.8% of low-risk patients. Among all patients, 84.1% received high-quality anticoagulation. Inappropriate antiarrhythmic drugs were prescribed in 7.2% of patients with permanent AF, 2.9% of those with structural heart disease, and 0.0% of those with end-stage kidney disease. Catheter ablation was offered to 70% of patients with symptomatic paroxysmal or persistent AF after the failure or intolerance of 1 antiarrhythmic drug. All modifiable risk factors were documented in 59.3% of patients. Rates of all-cause mortality, ischemic stroke or transient ischemic attack, and major bleeding were 8.1, 0.8, and 2.56 per 100 patients/y, respectively. QIs for anticoagulation and outcomes were similar between general cardiology and tertiary referral centers.

Conclusions

Although accredited centers in Spain demonstrated good performance in many of the ESC QIs for AF, there remains room for improvement. These data could serve as a starting point for enhancing the quality of care in this population.

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