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Development of a Care Pathway for Atrial Fibrillation Patients in the Emergency Department.
Do, Duc H; Bernardes-Souza, Breno; Merjanian, Michael; Lombardo, Brandan; Donaldson, David M; McCullough, Lynnell B; Boyle, Noel G; Cooper, Richelle J.
Affiliation
  • Do DH; From the UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Bernardes-Souza B; From the UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Merjanian M; UCLA Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Lombardo B; UCLA Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Donaldson DM; UCI Department of Cardiology, Irvine, CA.
  • McCullough LB; UCLA Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Boyle NG; From the UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Cooper RJ; UCLA Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Crit Pathw Cardiol ; 21(3): 105-113, 2022 09 01.
Article de En | MEDLINE | ID: mdl-35994718
ABSTRACT
Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence is continuously increasing in the United States, leading to a progressive rise in the number of disease-related emergency department (ED) visits and hospitalizations. Although optimal long-term outpatient management for AF is well defined, the guidelines for optimal ED management of acute AF episodes is less clear. Studies have demonstrated that discharging patients with AF from the ED after acute stabilization is both safe and cost effective; however, the majority of these patients in the United States and in our institution are admitted to the hospital. To improve care of these patients, we established a multidisciplinary collaboration to develop an evidence-based systematic approach for the treatment and management of AF in the ED, that led to the creation of the University of California-Cardioversion, Anticoagulation, Rate Control, Expedited Follow-up/Education Atrial Fibrillation Pathway. Our pathway focuses on the acute stabilization of AF, adherence to best practices for anticoagulation, and reduction in unnecessary admissions through discharge from the ED with expedited outpatient follow-up whenever safe. A novel aspect of our pathway is that it is primarily driven by the ED physicians, while other published protocols primarily involve consulting cardiologists to guide management in the ED. Our protocol is very pertinent considering the current trend toward increased AF prevalence in the United States, coupled with a need for widespread implementation of strategies aimed at improving management of these patients while safely reducing hospital admissions and the economic burden of AF.
Sujet(s)

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Fibrillation auriculaire Type d'étude: Guideline / Risk_factors_studies Limites: Humans Pays/Région comme sujet: America do norte Langue: En Journal: Crit Pathw Cardiol Sujet du journal: CARDIOLOGIA Année: 2022 Type de document: Article Pays d'affiliation: Canada

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Fibrillation auriculaire Type d'étude: Guideline / Risk_factors_studies Limites: Humans Pays/Région comme sujet: America do norte Langue: En Journal: Crit Pathw Cardiol Sujet du journal: CARDIOLOGIA Année: 2022 Type de document: Article Pays d'affiliation: Canada