Atrial Fibrillation

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.

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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.

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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.

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EP News – QI and Outcomes—Triaging AF Patients for Optimal Care

Journal Articles: Atrial fibrillation (AF) is a major public health concern that affects millions of people worldwide. AF is associated with increasing health care costs and a higher risk of stroke with increasing comorbidities and age. Despite well-written guidelines for AF care, standardized management is lacking. Therein lies an opportunity to create AF centers of excellence (AF CoEs) with a patient-centered integrated focus and approach that can benefit patients and health care providers (physicians, nurse practitioners, physician assistants, nurses, pharmacists and technologists) alike.

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Improving Electrophysiology Lab Efficiency: Collaboration With Anesthesiology is Well Worth the Time

Journal Articles: Many of the efforts to improve laboratory efficiency require close collaboration with our colleagues in anesthesia. Osorio et al1 outlined a standardized anesthetic protocol that was designed with the intention of improving effectiveness of lesion formation during AF ablation while also improving efficiency and ensuring patient safety.

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Suspected AF Pathway

Care Pathways/CDS: Clinical Pathway for Suspected AF

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SOP Procedure in the Event of Suspected Bleeding Complications after Punctures (Femoral Artery, Radial Artery, Brachial Artery, CVC)

Procedure in the Event of Suspected Bleeding Complications after Punctures (Femoral Artery, Radial Artery, Brachial Artery, CVC)

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SOP Pericardial Effusion or Tamponade After Atrial Fibrillation Ablation

SOP for Pericardial Effusion or Tamponade after AFib ablation procedure. Includes, steps to take with suspected tamponade, materials, and instructions.

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SOP OAC in Atrial Fibrillation With or Without PVI

SOP for oral anticoagulation for AFib patients with or without PVI. Includes flow chart, breakdown of CHADSVASC, dosage chart, and explanation of TEE management before PVI.

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SOP Deep Analgesic Sedation in the EPU Laboratory

Education – Clinical: Workflow for deep analgesic sedation in the EPU laboratory. Includes medications, monitoring, and ACT control.

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