{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:08:41Z","timestamp":1791425321718,"version":"4.3.3"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Care pathways for patients with atrial fibrillation (AF) are poorly understood and may influence the likelihood of guideline concordant oral anticoagulation or antiarrhythmic drug therapy and associated outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Adult patients in the Optum Clinformatics Database (2015\u20132023) with incident AF were identified. Care pathways, by treating clinician specialty (primary care, cardiology, electrophysiology) during each AF\u2010related visit in the 1 year post diagnosis were examined. Cox regression models were used to assess associations between an electrophysiologist visit and AF\u2010related treatments including antiarrhythmic drug therapy and oral anticoagulation and outcomes including AF\u2010related hospitalizations, heart failure hospitalizations, and stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Of the 37\u2009370 patients included, 7700 (20.6%) had a care pathway including an electrophysiologist visit. Older patients (70\u201379 and 80+ versus 18\u201349\u2009years: hazard ratio [HR], 0.71 [95% CI, 0.64\u20130.78] and HR, 0.57 [95% CI, 0.51\u20130.63], respectively) and those with a higher CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc score (2\u20133 and \u22654 versus 0\u20131: HR, 0.79 [95% CI, 0.74\u20130.85] and HR, 0.76 [95% CI, 0.68\u20130.84], respectively) were less likely to have an electrophysiologist visit. Electrophysiologist visits were associated with a significant increase in rates of treatment with antiarrhythmic drug and oral anticoagulation. Patients aged \u226580\u2009years with an electrophysiologist visit had significantly lower risks of stroke compared with those without an electrophysiologist visit (HR, 0.63 [95% CI, 0.42\u20130.95]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Certain demographic groups including older patients had lesser likelihood of electrophysiologist consultation, but guideline concordant care was more likely associated with electrophysiology care pathways. Electrophysiology care pathways were associated with improved outcomes especially among the groups with greatest stroke risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046111","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:08:40Z","timestamp":1774951720000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Patient Care Pathways and Outcomes Following Newly Diagnosed Atrial Fibrillation"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4848-4775","authenticated-orcid":false,"given":"Emily P.","family":"Zeitler","sequence":"first","affiliation":[{"name":"Dartmouth Health","place":["Lebanon, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0195-1081","authenticated-orcid":false,"suffix":"II","given":"Larry R.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Duke University Medical Center","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-0728","authenticated-orcid":false,"given":"Andrea","family":"Natale","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute","place":["Austin, USA"]},{"name":"University of Tor Vergata","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-2404","authenticated-orcid":false,"given":"Jonathan P.","family":"Piccini","sequence":"additional","affiliation":[{"name":"Duke University Medical Center","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4345-0816","authenticated-orcid":false,"given":"Sean D.","family":"Pokorney","sequence":"additional","affiliation":[{"name":"Duke University Medical Center","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3129-6161","authenticated-orcid":false,"given":"Andrea M.","family":"Russo","sequence":"additional","affiliation":[{"name":"Cooper University Hospital","place":["Moorestown, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2629-3476","authenticated-orcid":false,"given":"Roopinder K.","family":"Sandhu","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Khanna","sequence":"additional","affiliation":[{"name":"Johnson & Johnson","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4197-3955","authenticated-orcid":false,"given":"Maximiliano","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Johnson & Johnson MedTech Electrophysiology","place":["Toronto, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8571-3872","authenticated-orcid":false,"given":"Yiran","family":"Rong","sequence":"additional","affiliation":[{"name":"Johnson & Johnson","place":["New Brunswick, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5349-0136","authenticated-orcid":false,"given":"T. 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