Clinical and Economic Impact of an Organized Treatment Pathway on AFib Patient Management From the ER

Study Overview
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Brief Summary
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Investigators developed a multidimensional protocol for the management of AF in the emergency department. Investigators aimed to assess if this new ER AF management protocol would result in better outcomes compared to routine care.

Detailed Description
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Management variation such as selecting rate vs rhythm control, timing and need for thromboembolic treatment, ER vs inpatient treatment and cardiology consultation could lead to disparate care of patients. Therefore, there is a need for future studies to standardize practice leading to improved management, decreased rates of hospitalization and overall cost. Investigators developed a multidimensional protocol for the management of AF in the emergency department. Investigators aimed to assess if this new ER AF management protocol would result in better outcomes compared to routine care.

Official Title
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Clinical and Economic Impact of an Organized Treatment Pathway on Atrial Fibrillation Patient Management From the Emergency Room

Conditions
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Cardiac Arrhythmia, Atrial Fibrillation

Intervention / Treatment
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* Other: Quality improvement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consecutive patients > 18 years of age who comes to the ER with AF as the primary diagnosis and is treated according to study protocol. Exclusion Criteria: Patients with established cardiology or electrophysiology care.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study Arm<br>Patients who present with AF as the primary diagnosis to the ER will have their chart reviewed | Other: Quality improvement<br>* All patients with AF as primary problem treated with study protocol would be compared with historical cohort of AF patients who were treated with routine care in the ER. Patients will be followed up and outcomes will be compared between two groups at 1, 3, 6 and 12 months.<br>* Other names: All patients with AF as primary problem treated with study protocol would be compared with historical cohort of AF patients who were treated with routine care in the ER.;|
| Historical Cohort<br>Historical control arm will be selected from chart review of emergency department prior to the commencement of this study after propensity matching with age and sex. | Other: Quality improvement<br>* All patients with AF as primary problem treated with study protocol would be compared with historical cohort of AF patients who were treated with routine care in the ER. Patients will be followed up and outcomes will be compared between two groups at 1, 3, 6 and 12 months.<br>* Other names: All patients with AF as primary problem treated with study protocol would be compared with historical cohort of AF patients who were treated with routine care in the ER.;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumulative resource utilization in dollars | Primary Outcome | 15 months | 
| Time to definitive therapy (AAD and or Ablation) | Primary Outcome | 15 months | 
| Number of Hospital/clinic visits | Primary Outcome | 15 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Clinical and Economical impact, Treatment pathway, Emergency Room, Atrial Fibrillation