Atrial Fibrillation

Example of OhioHealth Outpatient (Non-ED) –> AFC for Acute or Non Acute Referral

This clinic is intended to reduce hospitalization and observation stays for low risk atrial fibrillation patients presenting to outpatient departments who are appropriate for outpatient management. Patients will be seen by an Electrophysiology APP within 48 hours. Please contact the rounding/on call Electrophysiologist if telephone consultation desired to determine if patient meets criteria for outpatient management.

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Confirmed AF Management Pathway

Care Pathways/CDS: Care pathway for management of confirmed AFib in patients. Includes information about underlying causes, treatment options, reducing stroke risk, and more.

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Clinical Pathway for People with Atrial Fibrillation or At Risk of Atrial Fibrillation

This clinical pathway has been prepared to support providers, public health commissioners and NHS commissioners to develop services and improve clinical practice for people with, or at risk of, atrial fibrillation (AF). It is hoped that it will prove to be a practical guide that will help to encourage discussion and collaboration between different stakeholders and help to deliver clinically effective and coordinated holistic services for people with AF or at risk of AF across the full pathway of care. This pathway focuses on the standard of care that one would expect to receive if suspected of AF or following a diagnosis of atrial fibrillation. It is also designed to support those stakeholders interested in, and working towards, a reduction in AF-related strokes. It does not, however, comprehensively cover every single clinical anomaly that may arise in clinical practice.

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Best Practices for Sleep and Weight Referrals

Best Practices: Best Practices for Sleep and Weight Referrals, including chart and visual care pathway.

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How and When to Ablate the Ligament of Marshall

Journal Articles: Article from Heart Rhythm that explains the process and methods for mapping and ablating the ligament of Marshall. Includes graphics, implications, and when to ablate.

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Guidelines for the Management of Atrial Fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)

Guidelines/Clinical Documents: Guidelines document outlining best practices for the management of AFib.

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Ablation of atrial fibrillation in an ambulatory outpatient setting

Journal Articles: Aim of study is to report the feasibility and safety of AF ablation in an ambulatory setting (Alaska Heart and Vascular Institute). Metrics include procedural complications, postoperative utilization of hospital services, and emergency room utilization.

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3D Mapping for PVI – Geometry, Image Integration and Incorporation of Contact Force Into Work Flow

Journal Articles: Catheter ablation of atrial fibrillation has evolved enormously thanks to rapid improvement of modern mapping technologies, progress in catheter development and current possibilities for reduction of radiation exposure. Pulmonary vein isolation is thereby the cornerstone in this interventional treatment. Increased precision of catheter localization by modern three-dimensional mapping systems, faster and better processing of local electrograms and their immediate color-based visualization make it possible to treat even challenging arrhythmias very effectively. The commonly used three-dimensional mapping systems CARTO 3 (Biosense Webster, Irvine, Ca.) and Ensite Precision (St. Jude Medical, St. Paul, Min) differ in construction and principles of the underlying mapping technology. In this review article, we aim to emphasize the most important aspects of possibilities that make both systems so valuable for interventional treatment of atrial fibrillation. We present a modern workflow, that unites three-dimensional LA mapping with collecting relevant local information, image integration for refining the map and beneficial use of contact force based ablation approach.

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Designing an Efficient and Quality-focused Integrated Atrial Fibrillation Care Center

Best Practices: Best practices for developing an efficient and quality-focused AF ablation program as part of a larger AF center of excellence, highlighting the experience of a single center and demonstrating how the same principles were adopted to implement a similar program at another institution.

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Patient in Room to Physician in Room

Data/Registries: This sample report shows performance over time of patient in room compared to physician in room and  patient in room access compared to when the patient arrives in the lab.

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