title: Troponin utilization in patients presenting with atrial fibrillation/flutter to the emergency department: retrospective chart review.
abstract: BACKGROUND
  There are few recommendations about the use of cardiac markers in the investigation and management of atrial fibrillation/flutter. Currently, it is unknown how many patients with atrial fibrillation/flutter undergo troponin testing, and how positive troponin results are managed in the emergency department. We sought to look at the emergency department troponin utilization patterns.
  
  
  METHODS
  We performed a retrospective chart review of patients with atrial fibrillation/flutter presenting to the emergency department at three centers. Outcome measures included the rates of troponins ordered by emergency doctors, number of positive troponins, and those with positive troponins treated as acute coronary syndrome (ACS) by consulting services.
  
  
  RESULTS
  Four hundred fifty-one charts were reviewed. A total of 388 (86%) of the patients had troponins ordered, 13.7% had positive results, and 4.9% were treated for ACS.
  
  
  CONCLUSIONS
  Troponin tests are ordered in a high percentage of patients with atrial fibrillation/flutter presenting to emergency departments. Five percent of our total patient cohort was diagnosed as having acute coronary syndrome by consulting services.
authors.affiliation: Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Canada. nmeshkat@rogers.com.
authors.forename: Nazanin
authors.initials: N
authors.lastname: Meshkat
authors.forename: Emily
authors.initials: E
authors.lastname: Austin
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Hatamabadi
authors.forename: Behzad
authors.initials: B
authors.lastname: Hassani
authors.forename: Ali
authors.initials: A
authors.lastname: Abdalvand
authors.forename: Amanda
authors.initials: A
authors.lastname: Marcuzzi