Rapid access arrhythmia clinic for the diagnosis and management of new arrhythmias presenting in the community: a prospective, descriptive study.
OBJECTIVE
To investigate whether a rapid access approach is useful for the evaluation of patients with symptoms suggestive of a new cardiac arrhythmia.


METHODS
Prospective, descriptive study.


METHODS
Secondary care based rapid access arrhythmia clinic in West London, UK.


METHODS
Patients referred by their general practitioner or the emergency department with symptoms suggestive of a new cardiac arrhythmia.


METHODS
Number of patients with a newly diagnosed significant arrhythmia. Number of patients with diagnosed atrial fibrillation. Number of eligible, moderate, and high risk patients treated with warfarin.


RESULTS
Over a 25 month period 984 referrals were assessed. The mean age was 55 years (range 20-90 years) and 56% were women. The median time from referral to assessment was one day. A significant cardiac arrhythmia was newly diagnosed in 40% of patients referred to the RAAC. The most common arrhythmia was atrial fibrillation, with 203 new cases (21%). Of these, 74% of eligible patients over 65 were treated with warfarin. Other arrhythmias diagnosed were supraventricular tachycardias (127 (13%)), conduction disorders (43 (4%)), and non-sustained ventricular tachycardia (21 (2%)). Vasovagal syncope was diagnosed for 53 patients (5%). The most frequent diagnosis was symptomatic ventricular and supraventricular extrasystoles (355 (36%)).


CONCLUSIONS
A rapid access arrhythmia clinic is an innovative approach to the diagnosis and management of new cardiac arrhythmias in the community. It provides a rapid diagnosis, stratifies risk, and leads to prompt initiation of effective treatment for this population.
Martins
J L
JL
Cardiovascular Medicine, National Heart and Lung Division, Charing Cross Campus, Imperial College, London W6 8RF, UK.
Fox
K F
KF
Wood
D A
DA
Lefroy
D C
DC
Collier
T J
TJ
Peters
N S
NS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000628:therapy; D003325:Coronary Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data
D005343:Fibrinolytic Agents