Stroke Risk Assessment Patient presents with irregular pulse AF Pathway Haemodynamic compromise or chest pain? Yes Arrange Emergency admission Clear onset within last 72 hours Discuss with on call cardiology Yes Stroke Risk Assessment If any risk factors (female>65, Male>75, any cardiovascular disease) anticoagulate No known risk factors-Look for risk factors then see above Take history and examination Bloods and ECG Stroke risk assessment (see note) Is the patient symptomatic of AF? Yes Optimize Apical Heart Rate (See note 3) Is the patient now asymptomatic? Refer for consideration of rhythm management. NB-Consider ablation therapy specialist No Is the resting apical heart rate >100bpm Yes Is the resting apical heart rate <100bpm Yes Patient Asymptomatic Stroke risk assessed (not on ASA) Heart rate<100bpm PATHWAY COMPLETE No Dr Matthew Fay Westcliffe Cardiology Service July 2013