title: Emergency department presentations for atrial fibrillation and flutter in Alberta: a large population-based study.
abstract: Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of AFF presentations and outcomes after ED discharge in Alberta.
  
  
  
  Provincial administrative databases were used to obtain all primary ED encounters for AFF during 1999 to 2011 for patients aged >35 years. Data extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Analysis included summaries and standardized rates.
  
  
  
  During the study period, there were 63,398 ED AFF visits from 32,104 distinct adults. Median ages for females and males were 75 and 67 years, respectively; more men (52%) and patients > 65 presented. Overall, the standardized rates remained similar (2.8 per 1,000 over the study period). Specific populations of human services recipients and First Nations had higher ED visit rates for AFF than other groups. Predictable daily, weekly, and monthly trends were observed. The ED visits were followed by numerous subsequent visits in non-ED settings; however, First Nations and women had lower rates of specialist follow-up.
  
  
  
  Annually, over 5,000 ED presentations of patients experiencing AFF occur in Alberta and admissions proportions are declining. While presentation rates across the province are stable, follow-up with physicians, consultation with cardiologists and health outcomes vary based on socio-economic, age, sex, and First Nations status. Further research is required to understand the causes and consequences of these inequalities and to standardize care.
authors.affiliation: Department of Pediatrics, University of Alberta, Rm 3-524, Edmonton Clinic Health Academy (ECHA) 11405 87 Avenue NW, Edmonton, AB, T6G 1C9, Canada. rhonda.rosychuk@ualberta.ca.|Women & Children's Health Research Institute, Edmonton, Canada. rhonda.rosychuk@ualberta.ca.
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Rosychuk
authors.affiliation: Department of Medicine, University of Alberta, University of Alberta Hospital, 2C2 Walter Mackenzie Building, 8440 112 Street, Edmonton, AB, T6G 2B7, Canada.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Graham
authors.affiliation: Department of Emergency Medicine, University of Alberta, University of Alberta Hospital, 1G1.42 Walter Mackenzie Building, 8440 112 Street, Edmonton, AB, T6G 2B7, Canada.|Alberta Health Services, Edmonton, Canada.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Holroyd
authors.affiliation: Women & Children's Health Research Institute, Edmonton, Canada.|Department of Emergency Medicine, University of Alberta, University of Alberta Hospital, 1G1.42 Walter Mackenzie Building, 8440 112 Street, Edmonton, AB, T6G 2B7, Canada.|Alberta Health Services, Edmonton, Canada.|School of Public Health, University of Alberta, Edmonton, Canada.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
mesh_terms: D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000208:ethnology*; D001282:Atrial Flutter / Q000453:epidemiology / Q000208:ethnology*; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010351:Patient Discharge; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D012959:Socioeconomic Factors
keywords: Administrative databases; Atrial fibrillation; Atrial flutter; Emergency department