{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:47:38Z","timestamp":1778003258029,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001530","name":"Canterbury Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the effectiveness and safety of the new clinical pathway for patients presenting to an ED with AF, incorporating community next\u2010working\u2010day follow\u2010up and more specific clinician guidance around medication prescribing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A before\u2010and\u2010after, retrospective cohort study comparing patients presenting to Christchurch ED with acute uncomplicated AF in the year before (\u2018hospital\u2010based\u2019 follow\u2010up) and after (\u2018community\u2010based\u2019 follow\u2010up) implementation of a new AF management approach. The \u2018community\u2019 pathway replaced hospital\u2010based review with a next\u2010day community follow\u2010up and introduced more specific anticoagulation recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1065 patients met inclusion criteria, with 531 presenting during the \u2018hospital\u2010based\u2019 pathway period and 534 during the \u2018community\u2019 pathway period. The spontaneous reversion rate was approximately 61% in both cohorts. Following the implementation of the community pathway, there was no increase in cardioversions (16.6% <jats:italic>vs<\/jats:italic> 20%, difference 3.5% [95% CI \u22121.4 to 8.3]), admission rates (32.8% <jats:italic>vs<\/jats:italic> 32.2%, difference \u2212\u20090.6% [95% CI \u22126.4 to 5.3]), or AEs (60\u2010day all\u2010cause mortality 1.3% <jats:italic>vs<\/jats:italic> 0.9%, difference\u2009\u2212\u20090.7% [95% CI \u22122.3 to 1]). Attendance at a follow\u2010up AF clinic improved from 92.9% to 98.1% (difference 5.2% [95% CI 0.7\u20139.7]). Clinician adherence to anticoagulation guidelines increased by 7% (95% CI 1.6\u201312.4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A \u2018rate\u2010and\u2010wait\u2019 strategy for managing acute uncomplicated AF continues to allow a significant proportion of patients to self\u2010revert to sinus rhythm, without requiring hospital admission or cardioversion procedures. Transitioning to an off\u2010site, community AF clinic is both safe and effective, demonstrating increased clinic attendance and improved adherence to anticoagulation guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.70049","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:03:01Z","timestamp":1748350981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Atrial fibrillation patients presenting to an emergency department successfully managed with a next\u2010day community follow\u2010up pathway: A before\u2010and\u2010after cohort study"],"prefix":"10.1111","volume":"37","author":[{"given":"Finn","family":"Brokenshire","sequence":"first","affiliation":[{"name":"Department of Surgery and Critical Care University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9475-0344","authenticated-orcid":false,"given":"John W","family":"Pickering","sequence":"additional","affiliation":[{"name":"Emergency Department Te Whatu Ora Waitaha Canterbury  Christchurch New Zealand"},{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim S","family":"Al\u2010Busaidi","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Clinical Simulation University of Otago  Christchurch New Zealand"},{"name":"Student Health and Support Lincoln University  Lincoln New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Than","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care University of Otago  Christchurch New Zealand"},{"name":"Emergency Department Te Whatu Ora Waitaha Canterbury  Christchurch New Zealand"},{"name":"Department of Emergency Medicine University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Troughton","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaleb","family":"Addy","sequence":"additional","affiliation":[{"name":"General Medicine Te Whatu Ora Te Toka Tumai Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8113-3814","authenticated-orcid":false,"given":"Laura R","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care University of Otago  Christchurch New Zealand"},{"name":"Emergency Department Te Whatu Ora Waitaha Canterbury  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005119"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000000198"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009024"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw233"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62343-0"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2021.08.018"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.02.001"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1900353"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.08.017"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2021.05.102"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.14240"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.14286"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.12786"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_2_9_20_1","first-page":"86","article-title":"Consensus pathways: evidence into practice","volume":"128","author":"McGeoch G","year":"2015","journal-title":"N. 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