Atrial fibrillation (AF) is a substantial burden on health care resources. Combined specialist and nurse-based AF clinics taking an integrated management approach to care are associated with a reduced risk of cardiovascular hospitalization, AF-related ED visit or death. We evaluated the health care utilization costs of an integrated management approach compared to usual specialty care of AF. We examined the health care costs of 413 patients with newly diagnosed AF in 3 emergency departments in Nova Scotia between January 1, 2011 – January 31, 2014. Patients were divided into pre-intervention (usual care; 228 patients) and intervention (integrated management; 185 patients) periods based on implementation of the intervention on November 1, 2011. The intervention consisted of a nurse-run, physician-supervised AF clinic that was previously shown to be associated with an overall benefit to cardiovascular morbidity and mortality. Our cost analysis examined costs related to cardiovascular hospitalization, ED visits, bleeding events, medications and operational overhead. The cost of the intervention was compared to the cost of usual care. Probabilistic sensitivity analyses were conducted to address uncertainty. We found that the AF clinic had greater operational overhead costs and medication costs (due to increased use of OACs) compared to usual care; usual care had greater bleeding event, hospitalization and ED costs relative to the AF clinic. The AF clinic was associated with an overall lower cost per patient of $1753.14 compared with a per-patient cost of $1885.10 with usual care. Results were robust to sensitivity analysis. The AF clinic intervention was the most cost saving strategy in more than two-thirds of simulations; it was associated with a cost savings of $152.28 per patient. If implemented for the 350,000 patients with atrial fibrillation in Canada, the integrated management approach in an AF clinic will save $53 million compared to usual specialty care. An integrated management approach to AF outperforms usual care, on an absolute per-patient cost basis. Annual cost-savings of $152.28 per patient should be considered by decision-makers in the context of overall benefit to cardiovascular morbidity and mortality associated with the integrated management approach to AF.