1. The Atrial Fibrillation Clinic in Llanelli
Dr Lena Marie Izzat
Consultant Cardiovascular Physician

2. Llanelli AF Clinic Went live January 2009
Invitations sent to Carmarthenshire catchment area GP’s
Open to all physicians, A&E department, CSNs and surgical pre-assessment clinics.

3. Who is Referred?
Newly diagnosed atrial fibrillation where cardiology advice is deemed suitable.
Patients with established diagnosis who require specialist input ( PAF or Chronic AF)

4. Required Assessment prior to Clinic Referral
Brief clinical and treatment history
Physical examination.
ECG essential.
FBC / U&E / glucose/ TFT
Optional referral for open access echocardiography

5. At the Clinic CV Risk Factor Assessment (Q Risk)
Physical Examination / ECG
CHADS II score
Referral to anticoagulant clinic if appropriate
Referral for Echo if appropriate
Management plan and decision on rhythm control or rate control strategy
Tertiary centre referral for non-pharmacological management if appropriate
Other CV tests arranged if needed (ETT / CAG)

6. Audit of 222 initial patients Referral Source

7. Age

8. CHADS 2 Score
N=222
Anticoagulation clinic referrals all seen on day of clinic

9. Referred for Echo on day of clinic
87%
N=222

10. Diagnosis
N=222

11. Decision
N=222

12. Conclusions
Team effort involving physicians, CSNs, cardiac technicians and anticoagulant service.
Patients assessed promptly and thoroughly
Investigations and anticoagulation decided and often initiated as one-stop.
Seamless transfer between departments.
Referral to tertiary centre for AF ablation in suitable patients when applicable.

13. Thank you