OBJECTIVES: Lifelong treatment for many chronic conditions, such as atrial fibrillation (AF), involves complex care pathways with numerous points of interaction between patients and healthcare providers. The EUPS-AF was conducted to assess patient-reported levels of satisfaction with current management of AF in Europe. METHODS: The EUPS-AF questionnaire was adapted from the 2008 Commonwealth Fund International Health Policy Survey of Chronically Ill Adults by including additional questions capturing AF-specific patient characteristics and treatment preferences. Computer-assisted telephone interviews were conducted between February and July 2011 via randomized digital dialling covering the entire adult populations of France, Germany, Italy, Spain and the UK. Questions covered the following nine domains: overview of the health system; ease of healthcare access; relationship with care providers; hospital experience; use of medication, coordination of polymedication and cost; safety concerns; experience with other chronic diseases; access to information; financial burden. RESULTS: Of the 340,476 individuals contacted, 1.08% were identified with AF; 1793 were eligible for inclusion after screening; 321 (17.6%) declined to participate. Interviews were conducted in 1507 adults (50% women); mean age 70 years. On average, 43% lived in a village or rural location. Mean number of people per household was two; 56% had an income below average; 54% had been hospitalized during the past 2 years, with an average of 2.2 comorbidities and 5.7 prescription medications. Overall satisfaction rates ranged from 37% (Italy) to 55% (UK). CONCLUSIONS: The EUPS-AF, undertaken uniquely from a patient perspective before the introduction of novel oral anticoagulants into clinical practice, provides additional and complementary data to clinical trials and registries and allows the detection of international variations in satisfaction levels of patients with AF. This can promote research into the causes of variation, focus where innovations may be beneficial, and may reduce inequalities in standards of care if these underlie the variations.