None listed
Conditions
Brief summary
The study aims to evaluate feasibility, safety and acceptability of an integrated community-based model-of-care for low risk patients with AF and to gather data that will allow this new model-of-care to be implemented system-wide. The research hypothesis is that it is feasible for Ambulance Victoria and specialist AF clinics to deliver an integrated safe and timely community-based model-of-care for AF patients with low risk acute presentations. By implementing a novel clinical pathway supported by cardiology consultation, paramedics can accurately and safely treat AF in the homes, avoiding the need for transport to ED.
Interventions
Atrial fibrillation (AF) patients (diagnosed by electrocardiogram (ECG), confirmed by study on-call cardiologist) will undergo a clinical risk assessment (specifically designed for this study) by ambulance paramedics. The intervention will be made available to patients identified as ‘low-risk’ only. Low-risk patients are defined as having none of the following: syncope, clinical heart failure, hypoxia, ischaemic chest pain, SBP<100 mmHg, active bleeding or severe symptoms. Low-risk patients will
Atrial fibrillation (AF) patients (diagnosed by electrocardiogram (ECG), confirmed by study on-call cardiologist) will undergo a clinical risk assessment (specifically designed for this study) by ambulance paramedics. The intervention will be made available to patients identified as ‘low-risk’ only. Low-risk patients are defined as having none of the following: syncope, clinical heart failure, hypoxia, ischaemic chest pain, SBP<100 mmHg, active bleeding or severe symptoms. Low-risk patients will receive a single dose of oral beta blocker, metoprolol 50mg, and single dose of oral anticoagulant, rivaroxaban 15mg, by ambulance paramedics. Patients are to be left at home for community management. The specialist AF clinic will contact the patient within 48 hours of ambulance attendance to organise tele-health or in-person appointment (as required). Trial participation will be voluntary; low-risk patients may refuse alternative care and receive standard care.
Sponsors
Ambulance Victoria
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults (18 years of age and over) Atrial fibrillation diagnosis (identified with ECG and confirmed by study on-call cardiologist)
Exclusion criteria
Patients who do not reside in the Melbourne Metropolitan area
Outcome results
None listed