Adherence to the ABC (Atrial fibrillation Better Care) pathway in the Balkan region: the BALKAN-AF survey

INTRODUCTION: The Atrial fibrillation Better Care (ABC) pathway provides a useful way of simplifying decision‑making considerations in a holistic approach to atrial fibrillation management.OBJECTIVES: To evaluate adherence to the ABC pathway and to determine major gaps in adherence in patients in the BALKAN‑AF survey.PATIENTS AND METHODS: In this ancillary analysis, patients from the BALKAN‑AF survey were divided into the following groups: A (avoid stroke) + B (better symptom control) + C (cardiovascular and comorbidity risk management)-adherent and -nonadherent management.RESULTS: Among 2712 enrolled patients, 1013 (43.8%) patients with mean (SD) age of 68.8 (10.2) years and mean CHA2DS2‑VASc score of 3.4 (1.8) had A+B+C-adherent management and 1299 (56.2%) had A+B+C-nonadherent management. Independent predictors of increased A+B+C-adherent management were: capital city (odds ratio [OR], 1.23; 95% CI, 1.03-1.46; P = 0.02), treatment by cardiologist (OR, 1.34; 95% CI, 1.08-1.66; P = 0.01), hypertension (OR, 2.2; 95% CI, 1.74-2.77; P CONCLUSIONS: Physicians' adherence to integrated AF management based on the ABC pathway was suboptimal. Addressing the identified clinical and system‑related factors associated with A+B+C-nonadherent management using targeted approaches is needed to optimize treatment of patients with AF in the Balkan region.