Clinical characteristics and outcomes of patients admitted with atrial fibrillation/atrial flutter to the Emergency Department

Abstract

Aim: To determine the clinical characteristics and outcomes of patients with atrial fibrillation/atrial flutter (AF) admitted to the Emergency Department (ED). Material and methods: Patients with AF at ED admission with cardiac palpitations only, thromboembolic complications, hemorrhagic complications, hemo¬dynamic instability, other non-traumatic diseases, and trauma. Demographics, vitals, comorbidities, ECG, laboratory findings, treatment, and survival were analyzed. Results: There were 247 patients (55.1% women, 44.9% men) admitted to the ED aged 73.8±13.0 . A total of 226 (79.8%) patients were brought to the ED by Emergency Medical Services, and 121 (49%) had palpitations as a reason for admission. The hospitalization rate was 34%. About 60% of patients were on antithrombotic treatment. Among 45 patients with AF discharged home who were not previously treated with anticoagulants, all but three patients without indications for antithrombotic therapy, received a recommendation to be treated with anticoagulants, but only half of them received a prescription. During the follow-up of 1025 (773-1197), days died 67 (27.1%) patients, and 30-day mortality was 5.3%. The lowest mortality was found in patients admitted due to cardiac palpitations. Conclusions:1. The patients with AF admitted to the ED constitute a group of patients with a high hospitalization rate. 2. The reason for the admission to the ED of patients with AF divides this population into subgroups with different outcomes in terms of mortality and hospitalization.3. The patients discharged home who did not have been earlier treated with anticoagulants received suitable recommendations, however, only about half of them received a prescription for an anticoagulant.