• All patients with atrial fibrillation should be offered anticoagulant or Aspirin if not appropriate

• Patients with recent onset of atrial fibrillation should be offered cardioversion within two months of diagnosis providing there are no contra-indications and that any precipitating factors are identified and treated

• All patients to have a recorded diagnosis of atrial fibrillation

A computer search revealed that 136 patients of a Practice population of ­ had a recorded diagnosis of atrial fibrillation

Of these 25% i.e. 30 were randomly selected for the audit in the age group of 56+

A separate audit of those under 55 years was undertaken i.e. 10 patients

Of the 30 > 55yrs the following was found

Male ® 11 Age range 58 – 83yrs

Female ® 19 Age range 59 – 98yrs

Those currently taking:

• Warfarin = 13

• Aspirin = 10+ 1? buying own as previously prescribed

• Neither = 4

Of those taking neither

• 1 x 59yrs Male One entry AF 6/99, but nil since

• 1 x 78rs Female Hyperthyroid diagnosed and treated ® AF

• 1 x 62yrs Female AF episodes 20yrs ago, but nil since

New episode 10/2000

• 1 x 59yrs Female Entry from hospital records – anticoagulants

inappropriate

• 1 x 66yr old male Elective dc cardioversion

• 1 x 60yr old female Uses prescribed increased doses of

Flicanide then reverts back to sinus rhythm

• 1 x 98yr old female Permanent pacemaker in situ for complete

heart block - AF under control

• 1 x 73yr old male Permanent pacemaker in situ for bradycardia

• Male 8 Age range 30 – 55yrs

• Female 2 Age range 29 – 46yrs

Those currently taking: Warfarin 2

Aspirin 3

Neither 5

Of those taking neither:

• 1 x 46yr old female One entry of AF with occasional history of

palpitations

• 1 x 30yr old male One entry of AF ? associated following chest

trauma – reviewed by a cardiologist

• 1 x 36yr old male Four entries of AF – investigated by a

cardiologist and discharged

• 1 x 29yr old female One entry of AF

• 1 x 41yr old male Spontaneous reversal on Digoxin – cardiology

referral

• 1 x 53yr old male Successful cardioversion

No other reference to cardioversion noted in remaining patients records

It could be seen during the audit that 8 out of 10 patients had had a cardiology review

• It would appear that those patients requiring either Warfarin or Aspirin are being prescribed as such

• Cardioversion is used in such a small percentage of patients

• A high percentage of patients have been referred for cardiology review/assessment at some point in their care

• It would appear that the audit standards are being achieved