ABSTRACT:
Atrial fibrillation (AF) is the most common cardiac arrhythmia1, associated with reduced physical functioning1–3, increased stroke risk1–3 and diminished quality of life4,5. While catheter ablation (CA) is guideline-recommended for symptomatic patients with paroxysmal AF or persistent AF without major risk factors1, disparities in access to catheter ablation persist6–8. Information provision, treatment pathway navigation, and patient-centered access experiences are insufficiently understood9,10, despite their relevance for equitable and timely specialist care. This study asks what barriers and facilitators shape patient-centered access to health care for AF-patients in Austria and Germany and aims to identify these factors using Levesque et al.’s framework on patient-centered access to care11. Semi-structured interviews (ongoing) are conducted with adult AF patients and medical professionals in Austria and Germany (n=22). Interviews explore patients’ care-seeking experiences, and perceived barriers and facilitators to accessing treatment. Interviews are audio-recorded, transcribed verbatim, and pseudonymized. Data is analyzed using a codebook-based thematic analysis. The development of themes is guided by—but not restricted to—the dimensions of the Levesque framework, which describes access as the interaction between dimensions of service accessibility and responding patients’ abilities11. Preliminary findings indicate substantial gaps in information provision, with many patients unaware of CA as a treatment option. Reported barriers include dismissiveness or limited engagement by physicians, receiving conflicting information about CA, long waiting times and limited availability of CA, and unequal abilities to navigate the healthcare system. Facilitators include private insurance, medical or health system knowledge, and strong informal support networks. The study highlights how structural and individual characteristics shape barriers and facilitators and thereby inequities in access to AF treatment in countries with universal healthcare systems like Austria and Germany. Findings inform the development of a structured questionnaire examining access barriers in a larger cross-country sample and contribute to public health debates on equitable access to specialized cardiovascular care.