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• W4380715047 abstract "Earlier work at our institution has shown that identification and treatment of atrial fibrillation (AF) is suboptimal in hospitalized patients. We set out to better characterize delays in the detection and management of AF, and to investigate their consequences We conducted a retrospective review of 425 consecutive clinically significant AF events (episodes lasting >5 mins) generated by automated algorithmic continuous telemetry analysis between 12/25/20 and 9/21/21 for patients admitted to the cardiology floor of UVA Medical Center. Time of onset/duration of episodes were automatically recorded, and detailed chart review was performed. AF events in patients that generated clinical responses were significantly longer (median 2850 secs (SD 3962 secs; n=95)) than events in patients whose event was not identified by care teams (median 480 (SD 9280 secs; n=152), p <.01). In patients who were clinically identified, the median delay to identification was 483 mins (SD 692 mins; n=95). Patients who had AF events identified by clinical care teams and received intervention (anticoagulation, rate limiting medication, anti-arrhythmic, IV fluid bolus or electrical cardioversion) within 60 minutes of the onset of the event had lower rates of subsequent AF-related complications (MI, stroke, heart failure or escalation of care) - those who received intervention within 60 minutes had subsequent AF-related complication rates of 10%, while who were intervened upon after 60 minutes had complication rates of 18%. Non-white patients were more likely to have their incident AF event missed by clinical care teams - among those patients who had AF identified, 85% were white, and 15% were non-white, while among patients who had AF but were not identified, 70% were white and 30% were non-white (p-value <0.05). In conclusion, incident AF detection and management in our hospital is markedly delayed, and these delays are consequential in terms of risk of subsequent AF-related complications. Likelihood of an AF event leading to clinical recognition also appears to depend on race. Our future work will investigate the use of automated clinical team alerting of incident AF events to shorten times to AF detection and management, and effects of that on AF related complications and outcomes." @default.
• W4380715047 created "2023-06-15" @default.
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• W4380715047 date "2022-11-08" @default.
• W4380715047 modified "2023-09-23" @default.
• W4380715047 title "Abstract 13288: Relationship Between the Detection of Atrial Fibrillation, Race and Complication Rate" @default.
• W4380715047 doi "https://doi.org/10.1161/circ.146.suppl_1.13288" @default.
• W4380715047 hasPublicationYear "2022" @default.
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