Atrial fibrillation and flutter are the most common arrhythmias (irregular heart rhythms) seen and treated in the emergency department. (ED) As a cardiac referral center, St Paul’s Hospital manages many patients with atrial fibrillation and flutter in the ED. Our research has emphasized safe, rapid discharge of patients that might previously have been admitted to hospital. Furthermore, we have demonstrated that stroke prevention is an important part of ED care. Finally, our team has identified vulnerable patients with atrial fibrillation and flutter who may be unexpectedly critically ill and who may not benefit from traditional care. Representatives from St Paul’s hospital were instrumental in writing evidence-based guidelines for ED treatment of this condition.

Selected publications.

Stiell IG, Scheuermeyer FX, Vadeboncoeur A, Angaran P, Eagles D, Graham ID, Atzema CL, Archambault PM, Tebbenham T, deWit K, McRae A, Cheung WJ, Deyell MW, Baril G, Mann R, Sahsi R, Upadhye S, Clement C, Brinkhurst J, Chabot C, Gibbons D, Skanes A. CAEP acute atrial fibrillation / flutter best practices checklist. CJEM. 2018. In press.

Barbic D, Harris D, Stenstrom R, Heilbron B, Kalla D, Christenson J, Scheuermeyer FX. Implementation of an emergency department atrial fibrillation and flutter pathway improves rates of appropriate anticoagulation, reduces length of stay and thirty day revisit rates for congestive heart failure. CJEM 2017. In press.

Scheuermeyer FX, Mackay M, Grafstein E, Pourvali R, Heslop C, Ward J, Heilbron B, McGrath L, Humphries K. There are sex differences in the demographics and risk profiles of emergency department patients with atrial fibrillation and flutter, but no apparent differences in ED management or outcomes. Acad Emerg Med, 2015; 22: 1067 – 75.

Scheuermeyer FX, Pourvali R, Rowe BH, Grafstein E, Heslop C, MacPhee J, Ward J, Heilbron B, McGrath L, Christenson J. Emergency Department Patients with Atrial Fibrillation or Flutter and an Acute Underlying Medical Illness May Not Benefit from Attempts to Control Rate or Rhythm. Ann Emerg Med. 2015; 65: 511 – 22.e2.

Scheuermeyer FX, Innes G, Pourvali R, Dewitt C, Grafstein E, Heslop C, Macphee J, Ward J, Heilbron B, McGrath L, Christenson J. Missed opportunities for appropriate anticoagulation among emergency department patients with uncomplicated atrial fibrillation or flutter. Ann Emerg Med. 2013; 62: 557 – 565e2.

Scheuermeyer FX, Grafstein E, Stenstrom R, Christenson J, Heslop C, Heilbron B, McGrath L, Innes G. Safety and efficiency of calcium channel blockers versus beta-blockers for rate control in patients with atrial fibrillation and no acute underlying medical illness. Acad Emerg Med. 2013; 20: 222 – 30.

Scheuermeyer FX, Grafstein E, Stenstrom R, Innes G, Heslop C, McPhee J, Pourvali R, Heilbron B, McGrath L, Christenson J. Thirty-Day and 1-Year outcomes of emergency department patients with atrial fibrillation and no acute underlying medical cause. Ann Emerg Med. 2012; 60: 755-65.

Scheuermeyer FX, Grafstein E, Heilbron B, Innes G. Emergency department management and 1-year outcomes of patients with atrial flutter. Ann Emerg Med, 2011; 57: 564-571.e2

Scheuermeyer FX, Grafstein E, Stenstrom R, Innes G, Poureslami I, Sighary M. Thirty-day outcomes of emergency department patients undergoing electrical cardioversion for atrial fibrillation or flutter. Acad Emerg Med. 2010; 17: 408-15