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Atrial fibrillation / flutter

ADULT

Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • New symptomatic atrial fibrillation/flutter without any of the following concerning features
      • haemodynamic instability
      • shortness of breath
      • chest pain
      • syncope/pre syncope/dizziness
      • evidence of pre-existuing QRS (delta waves)
      • neurological deficit indicative of TIA/stroke
    • Recurrent paroxysmal atrial fibrillation / flutter
    • Atrial fibrillation with signs of heart failure or reduced LV function that does not require presentation to Emergency
  • Category 2
    (appointment within 90 calendar days)
    • Chronic atrial fibrillation requiring management review (e.g. rate control, anticoagulation)

  • Category 3
    (appointment within 365 calendar days)
    • No Category 3 criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • FBC, ELFTs, TSH results
  • Include available ECGs, in particular those demonstrating the arrhythmia

3. Additional referral information Useful for processing the referral

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Past medical history and comorbidities
  • Family history of cardiac disease or sudden cardiac death
  • 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
  • CHA2DS2 VASC score

4. Request

Last updated: 23 July 2019