Atrial Fibrillation/Flutter

This condition is treated in the Cardiology clinic.

Pre-referral work-up

History

All referrals should comply with the referral standards. and must include:

• 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

Tests

• FBC
• UEC
• LFT
• TSH (ideally within 3mths)
• CMP (Ca. Mg, PO4)
• Nil
• ECGs (those demonstrating the arrhythmia)

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 for Atrial Fibrillation (AF) can be found on the HealthPathways Tasmania website.

For more information please see the HealthPathways Tasmania website.

Additional Information

Article - Initial Management of Cardiac Arrhythmias

Clinic appointments

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

Emergency

🚩 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.

Urgent (Category 1)

• New symtomatic atrial fibrillation/flutter without emergency referral concerning features:
  • recurrent paroxysmal atrial fibrillation/flutter
  • atrial fibrillation with signs of heart failure or reduced LV function that does not require presentation to emergency

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review.

We will endeavour to see these patients within one week, or sooner if clinically indicated.

Semi-urgent (Category 2)

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

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Mersey Community Hospital
Phone: 1800 636 455
Fax: 6441 5928

South

Wellington Clinics

General cardiology clinic enquiries and appointments:
Phone: 03 6166 0061
Fax: 03 6231 0101

Pacemaker and cardiac device enquiries and clinic appointments:
Phone: 03 6166 0064

Royal Hobart Hospital
Level 2 (D Block) - Cardiology and Echo Department

General cardiology clinic enquiries and appointments:
Phone: 03 6166 8620 or 03 6166 8860
Fax: 03 6234 3982

Nurse Practitioner: Chronic Cardiac Care/Heart Failure
Phone: 03 6166 7398

Pulmonary Hypertension Services
Phone: 03 6166 8034