The increasing burden of atrial fibrillation in acute medical admissions, an opportunity to optimise stroke prevention.

14 Feb 2018

Abstract Background Atrial fibrillation (AF) is a risk-factor for devastating stroke. We investigated whether active screening, careful inspection of medical notes and communication to general practitioners (GP) from stroke specialists could increase appropriate anticoagulation prescription. Methods Between 1/9/14 and 28/2/15 all patients admitted acutely to medicine were screened for AF at Cambridge University Hospital. Individualised letters were sent to GPs of patients who were felt would benefit from anticoagulation. Results 847 patients with AF (11% prevalence, 52% female, median; age 81.9 years, CHA2DS2–VASc 4.4) were identified. 671 patients (79.2%) had known AF, and 176 (20.8%) were diagnosed on admission. 112 individualised letters were sent to GPs after screening and identifying ‘at risk’ patients. A 91% response rate was achieved, resulting in additional 43 individuals being appropriately anticoagulated. Conclusions AF prevalence is significantly increasing among acute hospital admissions. Careful screening and identification allows safer prescription of anticoagulation.