فرآیند درمانی فیبریلاسیون دهلیزی در بیمارستان های ایران

 Background: Lack of attention to standardized guidelines has caused tragic outcome in patients with atrial fibrillation and ultimately increase of financial burden imposed on the community structure of the economic system. Therefore, the present study was aimed to assess the exposure of patients with atrial fibrillation.  Methods: A total of 506 patients with atrial fibrillation were evaluated. After setting the gold standard (America Heart Association protocol) and data collection, kappa (κ) coefficient was calculated for inter-rater reliability of the measures taken by physicians with the gold standard.  Results: The most common procedure was the use of digoxin in controlling the rate prescribed. Kappa coefficient obtained in this area with 0.12 (95% CI: 0.096-0.14), which was in poor condition means that the measures provided by physicians was far from the gold standard (p<0.0001). The kappa coefficient of anticoagulation therapy was also equal to 0.07 (95% CI: 0.001-0.14). Hence, the consistency of adopted procedure by physicians with the gold standard anticoagulation was low (p=0.023).  Conclusion: This study showed that a large percentage of physicians are not aware of the standards of care, and are using the old method. This may cause serious consequences and increased disease burden on patients and the healthcare system of the country.