Atrial Fibrillation
NHS Tayside RefGuide
Who to refer
Symptomatic individuals in whom a rhythm control (electrical or chemical cardioversion) is
Symptomatic individuals, on a rate-control AF strategy, in whom it has not been possible to achieve a heart rate <110/min at rest
The person is found to have significant valvular disease or left ventricular systolic dysfunction on echocardiography
Asymptomatic AF in patients <50 years old
AF plus other structural or electrical pathology
Who not to refer
Patients who are acutely unwell should be discussed with Acute Medicine on-call service.
Asymptomatic AF after primary care rate control management (unless <50yrs old as above)
Rate controlled AF (unless <50 years old as above)
Purely for anticoagulation decision
How to refer
SCI Gateway/Cardiology. Note that referral may be triaged to Nurse Led Atrial Fibrillation Clinic.
Include results of Bloods – FBC, U&E, LFTs, TSH, Cholesterol, Glucose and 12 Lead ECG and, if available, 24 hour tape summary (or other documentary evidence of AF).
Alternative to Referral
Non-urgent advice via SCI Gateway Advice Referral
Specialty Description
Atrial Fibrillation is managed by our team of Cardiologists and Specialist Nurses. Patients will be triaged to most appropriate clinic at vetting. This may be Nurse Led AF Clinic, cardiologist or both.
Newly Diagnosed Atrial Fibrillation/Flutter Schematic
Primary Care Management
GP to make initial assessment and discuss and prescribe anticoagulation as appropriate.
Include bloods to include – FBC, U&E, LFTs, TSH, Cholesterol, Glucose
12 Lead ECG.
Concise Primary Care management advice is available in here NICE Clinical Knowledge Summary Atrial Fibrillation