Atrial fibrillation / flutter

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    Atrial fibrillation

    • 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
    • Refer to HealthPathways for assessment and management information or local guidelines if available
    • Not all patients with an incidental finding of asymptomatic/rate-controlled AF have to be seen by a cardiologist if the general practitioner is comfortable caring for the patient.
    • In patients with new onset atrial arrhythmias (<48 hours), consider a fast-track approach via telephone contact with the nearest cardiology service for consideration of earlier cardioversion to minimize the burden of atrial arrhythmia.
    • Atrial fibrillation may impact on a patient’s medical fitness to drive.  The Queensland Government’s Transport and Motoring website and Austroads - Assessing Fitness to Drive website has advice about managing driving

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

Please insert the below information and minimum referral criteria into referral

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 (PDF, 5.5MB)

4. Request

  • Patient's demographic details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring practitioner details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • 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

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 12 December 2025

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