LAUSR

This is a retrospective cohort study with a before and after design, comparing the admission rate for patients with AFib during a one-year period before the initiation of a new management algorithm to a one-year period after the algorithm was introduced. Physicians were first instructed to determine whether the AFib was secondary to another important diagnosis, such as sepsis or pulmonary embolism. (These patients were admitted to hospital). Among the patients with primary AFib, physicians assessed for four high-risk criteria: hemodynamic instability, acute heart failure, syncope, and acute coronary syndrome. Patients with no high-risk criteria were managed with either rate or rhythm control and then discharged home with close outpatient follow-up. The admission rate for AFib patients fell from 80% in the before period to 67% after, with no change in emergency department return visits. This article is protected by copyright. All rights reserved.