Atrial fibrillation/flutter

This condition is treated in the Cardiology clinic.

Emergency Referral Criteria

Criteria for Emergency include: 

Atrial fibrillation/flutter with any of the following concerning features:

• haemodynamic instability
• shortness of breath
• chest pain
• syncope/pre-syncope/dizziness
• known Wolff-Parkinson-White
• neurological deficit indicative of TIA/stroke
• uncontrolled tachycardia/heart rate despite medical therapy

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Statewide Referral Criteria (SRC)

Criteria for referral to public hospital specialist clinic services

? Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Urgent (Category 1)

• New symptomatic atrial fibrillation/flutter without any of the Emergency Referral Criteria concerning features listed above
• Recurrent paroxysmal atrial fibrillation/flutter
• Atrial fibrillation with signs of heart failure or reduced LV function that does not require presentation to emergency

Semi-urgent (Category 2)

• Chronic atrial fibrillation requiring management review (e.g. rate control, anticoagulation)

Routine (Category 3)

• Nil category 3 criteria

Information to be included in the referral 

(referral may be returned without this)

Essential supporting information

Pathology

• FBC
• UEC
• LFT
• TSH (ideally within 3 months)
• CMP (Ca. Mg, PO4)

Imaging

• Nil essential

Investigations/other

• ECG (those demonstrating the arrythmia)

Additional information

• Heart rate
• Frequency of symptoms
• Assessment of thrombo-embolic risk (CHADS2 or CHADS-VASC score)
• Associated symptoms - angina, SOB
• Current and past medications and efficacy
• Cardiac risk factors
• Family history of cardiac disease or sudden cardiac death

Interim/GP management

To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.

Additional information which may be useful for triage:

• Any investigations relevant to any co-morbidities
• Other investigations (if available) e.g. echocardiogram report, CXR report, holter monitor report, sleep study report
• History of smoking, alcohol intake and drug use (including recreational drugs)
• Coagulation studies, magnesium, fasting lipid results

Interim management advice can be found on HealthPathways Tasmania.

For more information please see HealthPathways Tasmania

Additional resources

Article - Initial Management of Cardiac Arrhythmias

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