Arrhythmias & electrophysiologyRandomised controlled trial
Nurse-led vs. usual-care for atrial fibrillation
- Randomised controlled trial
- pre-specified subgroup analysis by centre experience
Authors' conclusion
Our trial failed to show that nurse-led care was superior to usual-care.
Study context
- Population
- Patients with AF (64 ± 10 years, 44% women, 57% CHA2DS2-VASc ≥ 2)
- Participants
- 1,375 patients
- Comparison
- Nurse-led care vs usual care
- Nurse-led caren = 671
- Usual-caren = 683reference
- Primary endpoint
- Composite of:
- CV death
- CV hospital admissions
- Follow-up
- 37 months
Primary result
As reported in the abstract
37 months
Hazard ratio
0.85
95% CI 0.69–1.04
P = 0.12
Events by treatment group
Nurse-led care
9.7% per year
164 of 671
Usual-care
11.6% per year
192 of 683
Nurse-led care vs Usual-care
HR 0.85 (95% CI 0.69–1.04); P = 0.12
Further findings
Anticoagulation in full accordance with guidelines
Cumulative adherence to guidelines-based recommendations
Primary endpoint by centre experience (pre-specified subgroup analysis)
- Nurse-led care vs usual-care HR, four experienced centres
- 0.52 (95% CI 0.37-to 0.71)
- Nurse-led care vs usual-care HR, four less experienced centres
- 1.24 (95% CI 0.94-1.63)
- P for interaction <0.001
Hospitalizations for arrhythmia events and for HF
- Arrhythmia hospitalizations, nurse-led care vs usual-care
- 124 vs. 161 (7.0% and 9.4% per year)
- HF hospitalizations, nurse-led care vs usual-care
- 14 vs. 22 (0.7% and 1.1% per year)
Original publication
Nurse-led vs. usual-care for atrial fibrillation. Eur Heart J. Published 23 September 2019. doi:10.1093/eurheartj/ehz666
Summarised from the published abstract; every number is checked against it