Evolving Atrial Fibrillation (AF) Care in New Zealand (NZ): A Nurse Specialist-Led Clinic Aiming to Improve Standardisation, Equity, Cost-Effectiveness, and Lifestyle Modification in AF Management

Abstract

Aim This study assesses the efficacy of a nurse specialist-led AF clinic in a large regional centre in New Zealand. We look specifically at the standardisation of care, lifestyle management, the impact on health equity, and the cost-effectiveness of these strategies. Method A retrospective analysis of the first year of the clinic’s establishment was conducted reviewing the outcomes, attendance, and adherence to management guidelines. The clinic follows up those presenting to the Emergency Department with a primary diagnosis of AF. After discharge, appointments are available within 48–72 hours of presentation. Results Over the first year, 247 appointments were made (Median age 66, interquartile range 58–76, 48% male, 75% NZ European). 168 patients were established on a rhythm control strategy, with 20 referred for ablation, 26 receiving cardioversions, and the remainder established on anti-arrhythmic medication. Lifestyle modifications were addressed with majority of these patients. Demographic data also highlighted, a need to focus on equity with only 17.4% of appointments attended by Māori and Pacific patients, lower than would be expected given relative disease burden. Conclusion The Nurse Specialist-led AF clinic is a positive step forward in AF management in this region of NZ. This clinic brings international standards to a local stage and throws a focus on our unique healthcare needs and an emphasis on equitable delivery of care. This clinic is scalable, effective, and an inclusive approach to AF care.