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Quality Improvement Topics

Care Pathways / Clinical Decision Support
+ 1 other(s)

Severe Bradycardia – Care Path for use in Regional EDs

Care Pathways/CDS: Care pathway for regional emergency departments when a patient presents with sever bradycardia. Includes decision support tool, stability criteria, and protocol suggestions.

Workflows
+ 1 other(s)

Proposal for Electrophysiology APP Privileges to Perform Electrical Cardioversions (ECV)

Workflows: Background, rationale, and suggested training and requirements for the proposal of EP APP privileges to perform ECV. Includes protocol and references.

Care Pathways / Clinical Decision Support
+ 1 other(s)

Patient ED AFib Card: Atrial Fibrillation Transitions of Care Triage Protocol

Care Pathways/CDS: Atrial Fibrillation Transitions of Care Triage Protocol

UNC Health Care
Journal Articles
+ 2 other(s)

Improved Procedural Efficiency of Atrial Fibrillation Ablation Using a Dedicated Ablation Protocol and Lean Management

Journal Articles: In this study the authors hypothesized that “Lean management” within a dedicated ablation protocol could standardize the pulmonary vein isolation (PVI) procedure and improve quality.

JACC: Clinical Electrophysiology
Journal Articles
+ 2 other(s)

Arrhythmias in Pregnancy

Journal Articles: Increasing maternal mortality and incidence of arrhythmias in pregnancy have been noted over the past 2 decades in the United States. Pregnancy is associated with a greater risk of arrhythmias, and patients with a history of arrhythmias are at significant risk of arrhythmia recurrence during pregnancy. The incidence of atrial fibrillation in pregnancy is rising. This review discusses the management of tachyarrhythmias and bradyarrhythmias in pregnancy, including management of cardiac arrest. Management of fetal arrhythmias are also reviewed. For patients without structural heart disease, bblocker therapy, especially propranolol and metoprolol, and antiarrhythmic drugs, such as flecainide and sotalol, can be safely used to treat tachyarrhythmias. As a last resort, catheter ablation with minimal fluoroscopy can be performed. Device implantation can be safely performed with minimal fluoroscopy and under echocardiographic or ultrasound guidance in patients with clear indications for devices during pregnancy. Because of rising maternal mortality in the United States, which is partly driven by increasing maternal age and comorbidities, a multidisciplinary and/or integrative approach to arrhythmia management from the prepartum to the postpartum period is needed. (J Am Coll Cardiol EP 2022;8:120–135) © 2022 by the American College of Cardiology Foundation.

Tools
+ 1 other(s)

AI Algorithm for Heparin Dosing During AF Ablation

Workflows: Improving the user experience of a cardiovascular information system via optimizing the data entry workflow and generating procedure notes with artificial intelligence.

Cardiovascular Digital Health Journal
Journal Articles
+ 1 other(s)

An Atrial Fibrillation Transitions of Care Clinic Improves Atrial Fibrillation Quality Metrics

Journal Articles: OBJECTIVES: This study sought to assess whether an atrial fibrillation (AF)–specific clinic is associated with improved adherence to American College of Cardiology (ACC)/American Heart Association (AHA) clinical performance and quality measures for adults with AF or atrial flutter; BACKGROUND: There are significant gaps in care of patients with AF, including underprescription of anticoagulation and treatment of AF risk factors. An AF specialized clinic was developed to reduce admissions for AF but may also be associated with improved quality of care.; METHODS: This retrospective study compared adherence to ACC/AHA measures for patients who presented to the emergency department for AF between those discharged to a typical outpatient appointment and those discharged to a specialized AF transitions clinic run by an advanced practice provider and supervised by a cardiologist. Screening and treatment for common AF risk factors was also assessed; RESULTS: The study enrolled 78 patients into the control group and 160 patients into the intervention group. Patients referred to the specialized clinic were more likely to have stroke risk assessed and documented (99% vs. 26%; p < 0.01); be prescribed appropriate anticoagulation (97% vs. 88%; p ¼ 0.03); and be screened for comorbidities such as tobacco use (100% vs. 14%; p < 0.01), alcohol use (92% vs. 60%; p < 0.01), and obstructive sleep apnea (90% vs. 13%; p < 0.01) and less likely to be prescribed an inappropriate combination of anticoagulant and antiplatelet medications (1% vs. 9%; p < 0.01).; CONCLUSIONS: An AF specialized clinic was associated with improved adherence to ACC/AHA clinical performance and quality measures for adult patients with AF. (J Am Coll Cardiol EP 2020;6:45–52) © 2020 by the American College of Cardiology Foundation.

JACC: Clinical Electrophysiology
Education: Clinical
+ 2 other(s)

Cardiac Electrophysiology Presentation

Education – Clinical: High level presentation exploring cardiac electrophysiology, including drugs, anatomy and physioogy, and cardiac action potential.

Journal Articles
+ 1 other(s)

Major drivers of healthcare system costs and cost variability for routine atrial fibrillation ablation

Journal Articles: Original research article published in Heart Rhythm 02, outlining a study from the University of Utah that measured the components of direct and indirect costs for routine AF ablation procedures, the variability of those costs, and the main factors driving ablation cost variability.

Heart Rhythm O2
Care Pathways / Clinical Decision Support
+ 1 other(s)

EP/ED Atrial Fibrillation Disposition Guide

Care Pathways/CDS: Decision support tool for clinicians to utilize after EKG confirms AFib or atrial flutter. Includes initial evaluation, AFib specifics, and decision options.

Ascension