Can I Send This Patient With Atrial Fibrillation Home From the Emergency Department?

Background: Atrial fibrillation (AF) is one of the most common dysrhythmias managed in the emergency department (ED) setting. Due to the variety of patient presentations and disease severity, most patients in the United States are admitted to the hospital. Clinical Question: In patients who present with AF, is there a reliable decision tool that clinicians can use to predict the risk of adverse outcome and determine who may be appropriate for discharge? Evidence Review: Studies retrieved included two prospective observational cohort studies and four retrospective observational studies. These studies evaluate the use of risk decision tools in predicting adverse outcomes in patients with AF. Conclusion: Based on the available literature, RED-AF, AFFORD, and the AFTER (complex, modified, and pragmatic) scores demonstrate modest predictive discrimination in predicting adverse events, but further validation is recommended.