Résumé
Atrial fibrillation (AF) is common, with an increasing prevalence in primary care. Complications are serious and expensive. New guidelines have been published in 2011 by the European and American societies of cardiology. The implementation of these guidelines in primary care is questionable. Decision algorithms for general practice based on validated clinical scores are proposed in this paper. The steps of an assessment of this procedure in general practice are then proposed.
FAMG-Score: Care approach in three stages, screening, care pathways, treatment is explained. Sreening and diagnosis are based on clinical examination and ECG. The care pathway is based on the EHRA score after exclusion of underlying heart disease. A referral decision algorithm helps the GP to decide when and how a patient should be referred to a cardiologist or an intensive care unit. Antiarythmic drugs prescription and anticoagulation based on the score CHA(2)DS(2)-VASc come next.
Plan development and validation of the FAMG-Score project is proposed. The appropriate management of AF based on validated scales must become the responsibility of GPs. GP academics should contribute.