Predicting Acute Underlying Conditions in Emergency Department Patients with Atrial Fibrillation

Many emergency department (ED) patients presenting with atrial fibrillation or flutter (AFF) will also have another underlying acute illness. Identifying these patients early in the ED course is difficult but allows for timely interventions directed at the underlying illness.

To derive a decision tool, researchers performed a retrospective chart review of patients with electrocardiogram-confirmed AFF at two Canadian EDs. Patients with ST-elevation myocardial infarction, cardiac arrest, and stroke symptoms were excluded. Blinded researchers abstracted data on demographics, comorbidities, ED evaluation, and acute underlying conditions (defined a-priori).

Of 1083 patients with AFF, 37% had an acute underlying condition. The most accurate model c…