Multimorbidity management in atrial fibrillation: The Polish perspective in the EHRA-PATHS study

Background: Atrial fibrillation (AF) is the most common arrhythmia which places a significant burden on individuals as well as the healthcare system. AF management requires a multidisciplinary approach in which tackling comorbidities is an important aspect.

Aims: This study aimed to evaluate how multimorbidity is currently assessed and managed and to determine if interdisciplinary care is undertaken.

Methods: 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.

Results: A total of 341 eligible responses were received, of which 35 (10%) were from Polish physicians. 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 palpitations/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).

Conclusions: 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.