Clinical Pharmacist with Atrial Fibrillation Clinic Island Health Victoria, British Columbia, Canada
Background: Antiarrhythmic drug therapy (AADT) is commonly used as a bridging strategy to catheter ablation for atrial fibrillation (AF) and atrial flutter (AFL) due to long procedural wait times. Patient education on safe and effective AADT use is essential. Many patient education materials in British Columbia include American Food and Drug Administration black box warnings, which may not align with Canadian standards and could mislead AF/AFL patients. This project aimed to improve AADT-related education within Island Health (IH) for patients with AF/AFL.
METHODS AND RESULTS: Videos were selected as the optimal tool to increase timely access to more nuanced education. An AF Clinic pharmacist, electrophysiologist, and IH Multimedia services co-developed education videos on amiodarone, dronedarone, sotalol, and 1C agents, which are hosted publicly at https://vimeo.com/showcase/11494695.
A quality improvement (QI) survey was conducted between January 13 to February 23, 2025. Adults (>18 years) being evaluated at an outpatient cardiology clinic for AF/AFL and considered for AADT were invited to participate post-appointment. After viewing the relevant video for their care, participants completed an anonymous two-part electronic survey: (1) the validated Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire and (2) 25 QI-specific questions assessing satisfaction, knowledge, treatment adherence, and anxiety related to AADT.
Of 48 patient surveys distributed, 29 were completed (60% response rate). Respondents were 52% male, 55% aged 71–80 years, and had a varied educational background (31% had grade 12 education or less). Patients reported a median AFEQT score of 62 (Interquartile range of 39 to 79) indicating moderate severity impact on quality of life from AF. Overall, survey participants reported improved understanding of potential side effects (100%), greater knowledge of benefits and role of AADT (93%), enhanced ability to advocate for AADT-related needs (86%), and increased confidence initiating or continuing therapy (76%) [see Table 3]. While most respondents (55%) reported a reduction in anxiety, 17% reported increased anxiety due to heightened awareness of possible side effects [see Figure 2].
Conclusion: Video-based education is a valuable adjunct to clinician-led discussions for AF/AFL patients on rhythm control therapy. Positive patient feedback underscores its clarity and accessibility, regardless of education level. Such videos also serve as a patient resource to reference or revisit if further questions arise. With increased anxiety acknowledged by some patients, clinician involvement remains essential to address individual concerns and guide informed decision-making.
