Atrial Fibrillation / flutter
Red flags
Consider immediate referral of patients with any of the following:
Ventricular tachyarrhythmias are potentially more serious as they can rapidly compromise cardiac output. These arrhythmias are:
- Ventricular tachycardia
- Torsade de Pointes
- Ventricular fibrillation
A small number of patients in AF/SVT may present as significantly compromised.
Concerning symptoms
- Syncope
- Severe dizziness
- Ongoing chest pain
- Increasing dyspnoea
Concerning signs
- Ventricular rate >150bpm
- Hypotension (systolic <90mmHg)
- Clinical heart failure
- A family history of sudden cardiac death
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- New atrial fibrillation/flutter without Red flags
- Recurrent paroxysmal atrial fibrillation / flutter
- Atrial fibrillation with signs of heart failure or reduced LV function that does not require presentation to Emergency
Category 2
Appointment within 90 days is desirable
- Chronic atrial fibrillation requiring management review (e.g. rate control, anticoagulation)
Category 3
Appointment within 365 days is desirable
- No Category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
- Not all patients have to be seen by a cardiologist if the general practitioner is comfortable caring for the patient.
- In patients with new onset atrial arrhythmias (<48 hours), consider a fast track approach via telephone contact with the nearest cardiology service for consideration of earlier cardioversion to minimize the burden of atrial arrhythmia.
- Refer to HealthPathways for assessment and management information if available
Referral requirements
A referral may be rejected without the following information.
- General referral information
- Details of relevant signs and symptoms
- Details of all treatments offered and efficacy
- Past medical history and comorbidities
- Family history of cardiac disease or sudden cardiac death
- FBC, ELFTs, TSH
- All available ECGs (including ECG showing arrhythmia)
Additional Referral Information (Useful for processing the referral)
- Other investigations (if available) eg echocardiogram report, CXR report, holter monitor report, sleep study report
- Coagulation studies, fasting lipid results, magnesium results
- CHADS2 VASC score
- Any investigations relevant to any co-morbidities
- History of smoking, alcohol intake and drug use (including recreational drugs)
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways
Login to Brisbane North Health Pathways:
brisbanenorth.