社区心律失常诊所快速通道诊断和处理新发心律失常的前瞻性、描述性研究

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Objective: To investigate whether a rapid access approach is useful for the ev aluation of patients with symptoms suggestive of a new cardiac arrhythmia. Desig n: Prospective, descriptive study. Setting: Secondary care based rapid access ar rhythmia clinic in West London, UK. Participants: Patients referred by their gen eral practitioner or the emergency department with symptoms suggestive of a new cardiac arrhythmia. Main outcome measures: Number of patients with a newly diagn osed significant arrhythmia. Number of patients with diagnosed atrial fibrillati on. Number of eligible, moderate, and high risk patients treated with warfarin. Results: Over a 25 month period 984 referrals were assessed. The mean age was 55 years (range 20-90 years) and 56%were women. The median time from referral to assessment was one day. A significant cardiac arrhythmia was newly diagnosed in 40%of patients referred to the RAAC. The most common arrhythmia was atrial fib rillation, with 203 new cases (21%). Of these, 74%of eligible patients over 65 were treated with warfarin. Other arrhythmias diagnosed were supraventricular tachycardias (127(13%)), conduction disorders (43 (4%)), and non-sustained ventricular tachycardia (21 (2%)). Vasovagal syn cope was diagnosed for 53 patients (5%). The most frequent diagnosis was sympto matic ventricular and supraventricular extrasystoles (355 (36%)). Conclusion: A rapid access arrhythmia clinic is an innovative approach to the diagnosis and m anagement of new cardiac arrhythmias in the community. It provides a rapid diagn osis, stratifies risk, and leads to prompt initiation of effective treatment for this population. Objective: To investigate whether a rapid access approach is useful for the ev aluation of patients with symptoms suggestive of a new cardiac arrhythmia. Design: Prospective, descriptive study. Participants: Patients referred by their gen eral practitioner or the emergency department with symptoms suggestive of a new cardiac arrhythmia. Main outcome measures: Number of patients with a newly diagnosed significant arrhythmia. Number of patients with diagnosed atrial fibrillati on. Number of eligible, Median, and high risk patients treated with warfarin. Results: Over a 25 month period 984 referrals were assessed. The mean age was 55 years (range 20-90 years) and 56% were women. The median time from referral to assessment was one day. A significant cardiac arrhythmia was newly diagnosed in 40% of patients referred to the RAAC. The most common arrhythmia was atrial fibrillation, with 203 new cases (21%). O Of these patients, 74% of eligible patients over 65 were treated with warfarin. Other arrhythmias were diagnosed were supraventricular tachycardias (127 (13%)), conduction disorders (43 (4%), and non- sustained ventricular tachycardia ). Vasovagal syn cope was diagnosed for 53 patients (5%). The most frequent diagnosis was symptomatic ventricular and supraventricular extrasystoles (355 (36%)). Conclusion: A rapid access arrhythmia clinic is an innovative approach to the diagnosis and m anagement of new cardiac arrhythmias in the community. It provides a rapid diagnosis, stratifies risk, and leads to prompt initiation of effective treatment for this population.
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