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Emergency Department Re-Presentation for Atrial Fibrillation and Atrial Flutter.

Damian P Redfearn1, Muhammad Ali Furqan1, Andres Enriquez1

  • 1Heart Rhythm Service, Queen's University, Kingston, Ontario, Canada.

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|December 20, 2015
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Patients with atrial fibrillation (AF) and atrial flutter (AFL) frequently use the emergency department (ED), often requiring hospital admission. This highlights a significant risk of re-presentation and adverse outcomes, emphasizing the need for better AF management.

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Area of Science:

  • Cardiology
  • Emergency Medicine
  • Public Health

Background:

  • Atrial fibrillation (AF) and atrial flutter (AFL) management is crucial for patient outcomes.
  • Understanding emergency department (ED) utilization patterns in AF/AFL patients is essential.

Purpose of the Study:

  • To assess the frequency and patterns of ED use by patients presenting with AF/AFL.
  • To analyze subsequent re-presentations and hospital admissions within a 12-month follow-up period.

Main Methods:

  • Retrospective cohort analysis of ED visits for AF/AFL from 2010-2012.
  • Data linkage with national databases for patient tracking and admission details.
  • Assessment of visit frequency, time between visits, admission rates, and length of stay.

Main Results:

  • 1361 patients accounted for 4783 ED visits (mean 2.8 visits/patient).
  • 69.7% of patients had subsequent ED visits within 12 months.
  • ED visits led to 1462 admissions (63.0% from repeat visits); stroke/TIA accounted for 80 return visits.

Conclusions:

  • ED presentation with AF/AFL is linked to high rates of re-presentation and hospital admission.
  • Inadequate anticoagulation was noted in a majority of stroke/TIA cases among returning patients.
  • Improved AF/AFL management strategies are needed to reduce ED burden and improve patient outcomes.