{"id":"eb33318e4e8d","type":"article","url":"https://hartvaat.nl/2019/12/01/geintegreerde-gespecialiseerde-af-poliklinieken-verlagen-totale-mortaliteit-post/","title":"Geïntegreerde gespecialiseerde AF-poliklinieken verlagen totale mortaliteit: post-hoc analyse","title_en":"Integrated specialized atrial fibrillation clinics reduce all-cause mortality: post hoc analysis of a randomized clinical trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","huisarts"],"tags":["acuut-hartfalen"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euz209","source_url":"https://doi.org/10.1093/europace/euz209","authors":["Jeroen M L Hendriks","Robert G Tieleman","Hubertus J M Vrijhoef","Petra Wijtvliet","Celine Gallagher","Martin H Prins","Prashanthan Sanders","Harry J G M Crijns"],"significance":7,"published":"2019-12-01","source_date":"2019-12-01","image":"","kennis":[],"congress":"","summary_en":"This post-hoc analysis showed that integrated specialized AF outpatient clinics reduce all-cause mortality, providing evidence that structured, multidisciplinary AF care improves not just process measures but hard clinical outcomes.","created":"2026-07-03T10:28:18Z","updated":"2026-07-03T13:27:29Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Post-hoc analyse die aantoont dat geïntegreerde gespecialiseerde AF-poliklinieken de totale mortaliteit verlagen. Onderbouwt het AF-CARE model.","abstract_original":"AIMS: An integrated chronic care programme in terms of a specialized outpatient clinic for patients with atrial fibrillation (AF), has demonstrated improved clinical outcomes. The aim of this study is to assess all-cause mortality in patients in whom AF management was delivered through a specialized outpatient clinic offering an integrated chronic care programme. METHODS AND RESULTS: Post hoc analysis of a Prospective Randomized Open Blinded Endpoint Clinical trial to assess all-cause mortality in AF patients. The study included 712 patients with newly diagnosed AF, who were referred for AF management to the outpatient service of a University hospital. In the specialized outpatient clinic (AF-Clinic), comprehensive, multidisciplinary, and patient-centred AF care was provided, i.e. nurse-driven, physician supervised AF treatment guided by software based on the latest guidelines. The control group received usual care by a cardiologist in the regular outpatient setting.After a mean follow-up of 22 months, all-cause mortality amounted 3.7% (13 patients) in the AF-Clinic arm and 8.1% (29 patients) in usual care [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.23-0.85; P = 0.014]. This included cardiovascular mortality in 4 AF-Clinic patients (1.1%) and 14 patients (3.9%) in usual care (HR 0.28; 95% CI 0.09-0.85; P = 0.025). Further, 9 patients (2.5%) died in the AF-Clinic arm due to a non-cardiovascular reason and 15 patients (4.2%) in the usual care arm (HR 0.59; 95% CI 0.26-1.34; P = 0.206). CONCLUSION: An integrated specialized AF-Clinic reduces all-cause mortality compared with usual care. These findings provide compelling evidence that an integrated approach should be widely implemented in AF management."}