Authors: (including presenting author): :
Lam HC(1), Fung SCA(1)
Affiliation: :
(1) Accident and Emergency Department, United Christian Hospital
Keyword 1: :
Atrial fibrillation
Keyword 2: :
Emergency Medicine Ward
Introduction: :
Atrial fibrillation (AF) is a common arrhythmia frequently encountered in the Emergency Department in Hong Kong. This study evaluates outcomes of fast AF management between 2022 and 2024 in the Emergency Medicine Ward (EMW) of United Christian Hospital, Hong Kong—a model emphasizing rate control and multidisciplinary care.
Objectives: :
This study aims to evaluate the clinical outcomes and effectiveness of a specialized fast AF management protocol from 2022 to 2024, focusing on rate control, multidisciplinary collaboration, and key metrics such as length of stay, discharge rates, mortality, and readmissions.
Methodology: :
A retrospective review was conducted of all patients admitted to the EMW with a primary diagnosis of AF with a ventricular rate >110 beats per minute. Management protocols include pharmacological rate control, continuous cardiac monitoring via telemetry, conjoint rounds with internal medicine specialists in selected cases—such as assessment for anticoagulation initiation, and pharmacists providing patient education before discharge. Key outcome measures included length of stay, discharge rate, mortality, and 28‑day readmission rates.
Result & Outcome: :
A total of 653 AF cases were reviewed, accounting for 6.37% of all EMW admissions during the study period. The mean length of stay was 42.35 hours. Of all patients, 81.1% were discharged directly from the EMW, with a mortality rate of 0%. The 28‑day readmission rate (to either EMW or medical wards) was 6.43%. This model provides an effective and safe environment for the management of patients with fast AF, demonstrating superior clinical safety and quality service without extended inpatient admission. Collaboration with internal medicine specialists and pharmacist-led education contribute to comprehensive, multidisciplinary care.
