Cengiz BURAK, Muhammed SÜLEYMANOĞLU, Serhat HAYME, Erkan BAYSAL, İlyas KAYA, Bernas ALTINTAŞ, Serhat GÜNLÜ

Girişimsel Kardiyologlar Arasında Atriyal Fibrilasyon Farkındalık Anketi Değerlendirmesi

ÖZGİRİŞ ve AMAÇ: Atriyal fibrilasyon (AF), farklı klinik durumlarda ortaya çıkabilir ve çeşitli tedavi seçeneklerine sahiptir. Bu nedenle, gerçek yaşam koşullarında klinik uygulama da heterojen olabilir. Bu araştırmanın temel amacı, invazif kardiyologların AF’ ye yaklaşımını ve bu konudaki tedavi yaklaşımlarını değerlendirmektir.YÖNTEM ve GEREÇLER: 2017 Girişimsel kardiyoloji kongresinde, katılımcıların rastgele seçildiği ancak katılımın gönüllük esasına dayandığı bir anket çalışması yapılmış ve 134 anket sonucu değerlendirilmiştir. Anket formu, i) AF’yi tanıma ve belirli durumlarda medikal tedavi yaklaşımları, ii) AF ablasyonu yaklaşımları ve iii) stent takılan hastalarda antikoagülasyon ve antiplatelet tedavinin yönetimi konularını içermiştir.BULGULAR: AF ve hafif mitral darlığı olan hastada, katılımcıların çoğu yeni oral antikoagülan kullanımını tercih ederken, katılımcıların dörtte biri vitamin K antagonisti kullanmayı tercih etmiştir. CHA2DS2-VASc skoru 0, hipertrofik kardiyomiyopatisi olan AF hastasında katılımcıların çoğu asetilsalisilik asit kullanmayı tercih etmiş, oral antikoagülan tercih oranı ise %33.58 olmuştur. Semptomatik AF hastalarında hekimlerin %73,88' i üçüncü ataktan sonra ablasyonu tercih etmiş. Akut miyokard enfarktüsü nedeniyle ilaç kaplı stent takılan hastalarda ikili antiplatelet tedavi ile beraber oral antikoagülasyon süresine bakıldığında, çoğunlukla 3 ay üçlü tedavi, 12 aya kadar ikili tedavi seçeneği tercih edilmiştir (%64.18).TARTIŞMA ve SONUÇ: Mevcut araştırma, girişimsel kardiyologlar arasında atriyal fibrilasyona yaklaşım konusunda farklılıklar ve bazı durumlarda kılavuzlarla uyumsuz yaklaşımlar olduğunu göstermiştir. Bu sonuç, kılavuzların yetersiz takibinden veya bazı konularda yeterli veri ile desteklenen net bir tavsiyenin bulunmayışından kaynaklı olabilir.

A Survey Among Invasive Cardiologists to Assess Their Awareness of Atrial Fibrillation

ABSTRACTINTRODUCTION: Atrial fibrillation (AF) may occur in different clinical situations and has various treatment options. Therefore, clinical practice in real-life conditions may also beheterogeneous. The main aim of this survey was to evaluate the treatment approaches taken by invasive cardiologists in response to AF.METHODS: At the 2017 interventional cardiology congress, a survey was conducted in which voluntary participants were randomly assigned, and 134 survey results were evaluated. The survey questionnaire covered topics of i) AF recognition andmedical treatment approaches in certain situations, ii) approaches to AF ablation, and iii) the management of anticoagulation and antiplatelet therapy in patients with recentstent implantations.RESULTS: Most participants preferred novel oral anticoagulation in patients with AF and mild mitral stenosis, but one-quarter of the participants preferred using VKA. ForAF patients with hypertrophic cardiomyopathy whose CHA2DS2-VASc score was zero, 58.96% of participants preferred acetylsalicylic acid. Regarding their approach toablation, 73.88% of physicians preferred ablation after third attack in symptomatic AF patients. When it came to the duration of prescribing oral anticoagulants in combinationwith dual antiplatelet therapy for patients with implanted drugeluting stents due to acute myocardial infarctions, 64.18% of physicians preferred to prescribe triple therapy for three months, followed by 12 months of dual therapy.DISCUSSION and CONCLUSION: The present survey showed differences in the approach to AF and, in some cases, incompatibility with the guidelines. This may be due to insufficient follow-up of the guidelines, or it may be due to a lack of clear recommendations supported by sufficient data on some subjects.

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