{"id":1627,"date":"2015-02-01T13:13:32","date_gmt":"2015-02-01T12:13:32","guid":{"rendered":"https:\/\/blogs.bmj.com\/heart-journalscan\/?p=1627"},"modified":"2015-11-12T16:59:15","modified_gmt":"2015-11-12T15:59:15","slug":"the-safety-clinical-trial-intensive-outpatient-follow-up-to-improve-outcomes-after-hospitalization-for-atrial-fibrillation","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/heart\/2015\/02\/01\/the-safety-clinical-trial-intensive-outpatient-follow-up-to-improve-outcomes-after-hospitalization-for-atrial-fibrillation\/","title":{"rendered":"The SAFETY Clinical Trial: Intensive Outpatient Follow-up to Improve Outcomes after Hospitalization for Atrial Fibrillation"},"content":{"rendered":"<p>The prevalence of atrial fibrillation (AF) is increasing with a concurrent rise in the number of hospitalizations for AF. The standard versus atrial fibrillation-specific management strategy (SAFETY) trial sought to test a nurse-led intervention following hospital discharge for chronic, non-valvular AF on patient outcomes of unplanned admission or all-cause death. Participants in the intervention arm received Holter monitoring and a home visit from a cardiac nurse within one to two weeks after discharge to tailor management of AF and comorbid disorders. After a median of 905 days of follow-up, 127 (76%) patients receiving the SAFETY intervention reached the primary endpoint compared to 137 (82%) patients receiving standard management (hazard ratio 0.97, 95% CI 0.76\u20131.23; p=0.85). <!--more-->When assessed as the proportion of the actual compared to the maximum possible number of days alive and not hospitalized, the SAFETY arm had a median of 900 (IQR 767\u20131025) of 937 maximum event-free days versus 860 (IQR 752\u20131047) of 937 maximum event-free days for the standard treatment group (effect size 0.22, 95% CI 0.21\u20130.23; p=0.04). There were no differences between groups in hospitalizations for AF, cardioversions, falls, bleeding events, acute coronary syndrome, or cerebrovascular events.<\/p>\n<p><b>Conclusions<\/b><\/p>\n<p>A nurse-led, home-based, multidisciplinary intervention among chronic AF patients following hospitalization improved the number of days alive and out of the hospital but not event-free survival or AF-specific secondary outcomes. However, the intensive nature of the intervention studied in the present trial may not be extensible to general practice.<\/p>\n<p>Summarized by Jehu S. Mathew and Steven M. Bradley<\/p>\n<ul>\n<li>Stewart S, Ball J, Horowitz JD, Marwick TH, Mahadevan G, Wong C, Abhayaratna WP, Chan YK, Esterman A, Thompson DR, Scuffham PA, Carrington MJ. Standard versus atrial fibrillation-specific management strategy (SAFETY) to reduce recurrent admission and prolong survival: pragmatic, multicentre, randomised controlled trial. Lancet. 2014 Nov 17. pii: S0140-6736(14)61992-9.<\/li>\n<\/ul>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The prevalence of atrial fibrillation (AF) is increasing with a concurrent rise in the number of hospitalizations for AF. The standard versus atrial fibrillation-specific management strategy (SAFETY) trial sought to test a nurse-led intervention following hospital discharge for chronic, non-valvular AF on patient outcomes of unplanned admission or all-cause death. Participants in the intervention arm [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/heart\/2015\/02\/01\/the-safety-clinical-trial-intensive-outpatient-follow-up-to-improve-outcomes-after-hospitalization-for-atrial-fibrillation\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":47,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[281],"tags":[528],"class_list":["post-1627","post","type-post","status-publish","format-standard","hentry","category-electrophysiology","tag-atrial-fibrillation"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The SAFETY Clinical Trial: Intensive Outpatient Follow-up to Improve Outcomes after Hospitalization for Atrial Fibrillation - Heart<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/heart\/2015\/02\/01\/the-safety-clinical-trial-intensive-outpatient-follow-up-to-improve-outcomes-after-hospitalization-for-atrial-fibrillation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The SAFETY Clinical Trial: Intensive Outpatient Follow-up to Improve Outcomes after Hospitalization for Atrial Fibrillation - Heart\" \/>\n<meta property=\"og:description\" content=\"The prevalence of atrial fibrillation (AF) is increasing with a concurrent rise in the number of hospitalizations for AF. 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