1. 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