To investigate the impact of atrial fibrillation better care (ABC) pathway on the prognosis of Chinese emergency patients with atrial fibrillation (AF).

This study included patients with AF who presented to the emergency department of 20 hospitals in China from November 2008 to October 2011, and every patient had a 12-months follow-up. Patients were divided into 2 groups according to whether they followed the ABC pathway: ABC adherent and Non-ABC adherent. The primary clinical outcome measure was all-cause death, and the secondary clinical outcome measure was cardiovascular death, stroke, and major bleeding. Univariate and multivariable Cox regression models were used to analyze the effects of the ABC adherence on the clinical outcomes.

A total of 2 015 patients with AF were included in this study.The average age was (68.5±13.3) years, 1 104 (54.8%) were female, and the patients in the ABC/Non-ABC adherent were 126 (6.3%,126/2 015) and 1 889 (93.7%,1 889/2 015), respectively. During the 12-month follow-up, all-cause death and cardiovascular death occurred in 4 (3.2%, 4/126) patients and 1 (0.8%,1/126) in the ABC adherent group, and 275 (14.6%, 275/1 889) and 163 (8.6%, 163/1 889) in the Non-ABC adherent group. Multivariable Cox model analysis showed that the risk of all-cause mortality (HR 0.211, 95% CI 0.078~0.572, P=0.002) and cardiovascular mortality (HR 0.085, 95% CI 0.012~0.612, P=0.014) were significantly decreased in the ABC adherent group compared with the Non-ABC adherent group. The incidence of stroke and major bleeding was not statistically different between the two groups.

In a contemporary cohort of Chinese emergency patients with AF, comprehensive clinical management with the ABC pathway was associated with a significant decrease in the risk of all-cause death and cardiovascular death, and integrated management using the ABC pathway could improve the prognosis of patients with AF.