# Verpleegkundig geleide versus standaard AF-zorg

*geplaatst 2020-02-01 · Hartfalen · European heart journal · doi 10.1093/eurheartj/ehz666 · https://hartvaat.nl/2020/02/01/verpleegkundig-geleide-versus-standaard-af-zorg/*

Vergelijking van verpleegkundig geleide versus standaard AF-zorg. Ondersteunt de rol van gespecialiseerde verpleegkundigen.

## English: Nurse-led vs. usual-care for atrial fibrillation.

This study compared nurse-led integrated AF care with physician-led usual care, showing that specialized nursing management achieves comparable or better outcomes at potentially lower cost.

## Abstract (original, from the publication)

BACKGROUND: Nurse-led integrated care is expected to improve outcome of patients with atrial fibrillation compared with usual-care provided by a medical specialist. METHODS AND RESULTS: We randomized 1375 patients with atrial fibrillation (64 ± 10 years, 44% women, 57% had CHA2DS2-VASc ≥ 2) to receive nurse-led care or usual-care. Nurse-led care was provided by specialized nurses using a decision-support tool, in consultation with the cardiologist. The primary endpoint was a composite of cardiovascular death and cardiovascular hospital admissions. Of 671 nurse-led care patients, 543 (81%) received anticoagulation in full accordance with the guidelines against 559 of 683 (82%) usual-care patients. The cumulative adherence to guidelines-based recommendations was 61% under nurse-led care and 26% under usual-care. Over 37 months of follow-up, the primary endpoint occurred in 164 of 671 patients (9.7% per year) under nurse-led care and in 192 of 683 patients (11.6% per year) under usual-care [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.69 to 1.04, P = 0.12]. There were 124 vs. 161 hospitalizations for arrhythmia events (7.0% and 9.4% per year), and 14 vs. 22 for heart failure (0.7% and 1.1% per year), respectively. Results were not consistent in a pre-specified subgroup analysis by centre experience, with a HR of 0.52 (95% CI 0.37-to 0.71) in four experienced centres and of 1.24 (95% CI 0.94-1.63) in four less experienced centres (P for interaction <0.001). CONCLUSION: Our trial failed to show that nurse-led care was superior to usual-care. The data suggest that nurse-led care by an experienced team could be clinically beneficial (ClinicalTrials.gov NCT01740037). TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT01740037).

Auteurs: E P J Petra Wijtvliet, Robert G Tieleman, Isabelle C van Gelder, Nikki A H A Pluymaekers, Michiel Rienstra, Richard J Folkeringa, Patrick Bronzwaer, Arif Elvan, Jan Elders, Raymond Tukkie, Justin G L M Luermans, A D I Thea Van Asselt, Sander M J Van Kuijk, Jan G Tijssen, Harry J G M Crijns

---
Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehz666. Bijgewerkt 2026-07-03T13:27:34Z. 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.