Patient demographics, medical history, and anti- coagulation ... METHODS: Patients attending ED with a history of AF were ... A telephone questionnaire was.
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Patients < 65 years old; AF recorded in the intensive care or coronary care unit; and death during admission were excluded. Patient demographics, medical history, and anticoagulation status were recorded. Stroke risk was classified according to CHADS2 scoring system. RESULTS: Of 3,080 patients, 42% were female. Women with ECG-documented AF were significantly older than men (818 vs. 777 years, p < 0.0001). Clinical characteristics of hospitalized patients by gender are described in Table 1. Among high stroke risk hospitalized patients with a CHADS22, there was no difference between anticoagulant use at discharge in women vs. men; warfarin (49% vs. 46%, p¼NS) or novel oral anticoagulants (NOAC) (11% vs. 10%, p¼NS). Among hospitalized patients between the ages of 65-74 years old, slightly more women than men were on warfarin (43% vs. 37%, p¼0.0495). NOAC use was similar between genders at hospital discharge (10% vs. 8%, p¼NS). Among hospitalized patients over the age of 75 years old, there was no significant difference in the prescription of warfarin between women and men (48% vs. 46%, p¼NS) or NOACs (9% vs. 9%, p¼ NS). CONCLUSION: Among patients admitted to an academic hospital with ECG-documented AF and guideline-indicated for stroke prevention with anticoagulants, there was no difference in anticoagulant use between men and women at hospital discharge. Overall, anticoagulant use appears to be suboptimal.
BMS/Pfizer Alliance
Canadian Journal of Cardiology Volume 33 2017
attendances to the emergency department (ED), the precise reasons why patients decide to attend and the outcomes from these visits are unknown. OBJECTIVE: We sought to understand why patients with a known history of AF attend the ED, what their perceptions are of the outcomes of the visit and what alternatives could be considered. METHODS: Patients attending ED with a history of AF were identified using the hospital’s patient care system. Baseline data was obtained from their records. A telephone questionnaire was then conducted within 1 week of the initial presentation. The patients were asked a series of questions pertaining to their decision to attend the ER, the resultant outcomes, as well as alternative strategies which could be considered. RESULTS: Of the 102 patients who agreed to take part in the survey (mean age 69.54 12.46 years; 52% male, 48% female), sixty-five (63.7%) patients attended ED based predominantly on their symptoms at that time, 22 (21.6%) of patients attended based on prior advice, 9 (8.8%) of patients attended based on a combination of both, while 6 (5.9%) were unsure. A total of 53 (52%) of patients felt that something bad would happen if they did not attend the ED including the fear of having a stroke in 12 (11.8%) and the fear of having a heart attack in 29 (28.4%) of patients. Hospital admission occurred for 15 (14.7%) patients. Patients were assessed by cardiology in ED in 36 (35.3%) cases. A total of 57 (55.9%) patients felt an improvement in their symptoms following attendance to the ER. Overall, 47 (46.1%) patients were unaware of an alternative management strategy, 40 (39.2%) patients perceived benefit from a telephone advice line and 10 (9.8%) patients thought a smartphone application may be useful. CONCLUSION: Although most patients present to the ER based solely on symptoms, a significant number of patients (21.6%) presented based on previous advice. A substantial percentage of patients also do not gain any perceivable improvement in their symptoms. Greater use of telephone advice and to a lesser degree a smartphone application may be helpful in reducing ER attendances.
100 PSYCHOLOGICAL FACTORS ASSOCIATED WITH SELF-REPORTED SYMPTOM BURDEN, QUALITY OF LIFE AND HEALTH CARE USAGE AMONG PAROXYSMAL ATRIAL FIBRILLATION PATIENTS P Prior, Y Xue, A Ali, N Suskin, A Skanes
099 PATIENT SPECIFIC REASONS FOR ATTENDING THE EMERGENCY DEPARTMENT IN THE SETTING OF ATRIAL FIBRILLATION K Hong, D Wan, S Haseeb, B Zile, D Hart, A Graham-Kennedy, Z Mariano, P Leong-Sit, P Dorian, B Glover Toronto, Ontario BACKGROUND:
Despite the fact that patients with atrial fibrillation (AF) account for a significant percentage of
London, Ontario BACKGROUND: Atrial fibrillation (AF) is associated with distressing symptoms, impaired quality of life (QoL) and hospital readmissions. Anxiety sensitivity (AnxS), a cognitive trait, predisposes individuals to interpret autonomic changes as harmful. AnxS measured with the Anxiety Sensitivity Index (AnxSI), has been associated with AF symptoms independently of objective disease variables. The more recently developed AnxSI-R provides dimensional scores including fear of cardiovascular/somatic
