Anticoagulation for Atrial Fibrillation: Should Emergency Physicians be Responsible?

Discharging eligible patients from the ED without anticoagulation is called inappropriate in this retrospective study.

Patients with atrial fibrillation who are at high risk for stroke should receive anticoagulants. In a retrospective study of patients with atrial fibrillation or flutter who were discharged from two Canadian emergency departments (EDs) after treatment solely by emergency physicians, researchers ascertained the proportion of eligible patients who received anticoagulation.

Of 657 patients with atrial fibrillation and 75 with flutter, 151 were deemed retrospectively to be good candidates for starting anticoagulation (CHADS score >0 and no underlying illness). Of these 151 patients, 53% had been discharged home without anticoagulation and with no reason provided by the emergency physician and no instructions to discuss anticoagulation with a pri…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Anticoagulation for Atrial Fibrillation: Should Emergency Physicians be Responsible?

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Reviewing Author