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Atrial fibrillation - Management
When should I admit or refer someone with atrial fibrillation?
- Admit (or refer) for urgent assessment and intervention if the person has any of the following:
- A rapid pulse (greater than 150 beats per minute) and/or low blood pressure (systolic blood pressure less than 90 mmHg).
- Loss of consciousness, severe dizziness, ongoing chest pain, or increasing breathlessness.
- A complication of atrial fibrillation (AF), such as stroke, transient ischaemic attack, or acute heart failure.
- Refer people with new-onset AF to a specialist in cardiology if:
- The person is young (for example less than 50 years of age).
- Paroxysmal AF is suspected.
- Rhythm control is the preferred treatment, or there is uncertainty regarding this (see Rate or rhythm control).
- Drug treatment for rate control or antithrombotic treatment that can be used in primary care are contraindicated.
- The person is found to have valve disease or left ventricular systolic dysfunction on echocardiography.
- Wolff–Parkinson–White syndrome or a prolonged QT interval is suspected on the electrocardiogram.
- Heart rate is difficult to control, or the person continues to have symptoms despite rate-control treatment (see Management after starting rate-control treatment).
In depth
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