Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Oct;30(8):1581-7.
doi: 10.1016/j.ajem.2011.09.019. Epub 2011 Nov 17.

Prevalence of validated risk factors for developing atrial fibrillation--can we identify high-risk ED patients?

Tyler W Barrett  1 , Stephanie A Couch, Cathy A Jenkins, Alan B Storrow
Affiliations

Prevalence of validated risk factors for developing atrial fibrillation--can we identify high-risk ED patients?

Tyler W Barrett et al. Am J Emerg Med. 2012 Oct.

Abstract

Objective: The aim of this study was to investigate whether emergency department (ED) patients who were newly diagnosed with atrial fibrillation (AF) displayed risk factors for incident AF on prior ED visits.

Methods: This was a secondary analysis of a retrospective cohort study of ED patients with symptomatic AF at a tertiary referral center. We selected patients who were newly diagnosed with AF between July 1, 2005, and August 31, 2008, and had at least 1 ED visit before their diagnosis. We calculated the Framingham Heart Study AF risk score for each visit by documenting the presence of the risk factors (age, sex, body mass index, systolic blood pressure, hypertension treatment, PR interval, and ages of clinically significant cardiac murmur and heart failure diagnosis).

Results: Of the 296 patients newly diagnosed with AF, 115 (39%) had at least 1 prior ED visit resulting in 454 ED visits for analysis. The median time from first to last visit was 4 years (interquartile range [IQR], 2.1-5.9). The median age was 66 years (IQR, 49-79 years). Home medications included antihypertensives in 81% of visits, and 60% of visits with available electrocardiograms had a PR interval of 160 milliseconds or more. Heart failure history was reported in 23% of visits. The median AF risk score was 8 (IQR, 4-10) corresponding to a 16% 10-year predicted risk.

Conclusions: Nearly 40% of patients diagnosed with new AF had previous ED visits and displayed validated risk factors for incident AF. The ED provides an opportunity to identify and educate these patients as well as refer them for primary prevention interventions.

PubMed Disclaimer

References

    1. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285(18):2370–5. - PubMed
    1. McDonald AJ, Pelletier AJ, Ellinor PT, Camargo CA., Jr Increasing US emergency department visit rates and subsequent hospital admissions for atrial fibrillation from 1993 to 2004. Ann Emerg Med. 2008;51(1):58–65. - PubMed
    1. Benjamin EJ, Chen PS, Bild DE, et al. Prevention of atrial fibrillation: report from a national heart, lung, and blood institute workshop. Circulation. 2009;119(4):606–18. - PMC - PubMed
    1. Hart RG, Halperin JL. Atrial Fibrillation and Thromboembolism: A Decade of Progress in Stroke Prevention. Ann Intern Med. 1999;131:688–695. - PubMed
    1. Kim MH, Johnston SS, Chu BC, et al. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011 doi: 10.1161/CIRCOUTCOMES.110.958165. Available at: http://circoutcomes.ahajournals.org. - DOI - PubMed

Publication types