{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:26:34Z","timestamp":1780568794023,"version":"3.54.1"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,2,23]]},"abstract":"\n Background<\/jats:title>\n Atrial fibrillation (AF) is a common, growing, and costly medical condition. We aimed to evaluate the impact of a management algorithm for symptomatic AF that used an emergency department observation unit on hospital admission rates and patient outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n This retrospective cohort study compared 563 patients who presented consecutively in the year after implementation of the algorithm, from July 2013 through June 2014 (intervention group), with 627 patients in a historical cohort (preintervention group) who presented consecutively from July 2011 through June 2012. All patients who consented to have their records used for chart review were included if they had a primary final emergency department diagnosis of\n AF<\/jats:styled-content>\n . We observed no significant differences in age, sex, vital signs, body mass index, or\n CHADS<\/jats:styled-content>\n 2 (congestive heart failure, hypertension, age, diabetes mellitus, and prior stroke or transient ischemic attack) score between the preintervention and intervention groups. The rate of inpatient admission was significantly lower in the intervention group (from 45% to 36%;\n P<\/jats:italic>\n <0.001). The groups were not significantly different with regard to rates of return emergency department visits (19% versus 17%;\n P<\/jats:italic>\n =0.48), hospitalization (18% versus 16%;\n P<\/jats:italic>\n =0.22), or adverse events (2% versus 2%;\n P<\/jats:italic>\n =0.95) within 30\u00a0days. Emergency department observation unit admissions were 40% (\n P<\/jats:italic>\n <0.001) less costly than inpatient hospital admissions of \u22641\u00a0day's duration.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Implementation of an emergency department observation unit\n AF<\/jats:styled-content>\n algorithm was associated with significantly decreased hospital admissions without increasing the rates of return emergency department visits, hospitalization, or adverse events within 30\u00a0days.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002984","type":"journal-article","created":{"date-parts":[[2016,2,9]],"date-time":"2016-02-09T04:17:15Z","timestamp":1454991435000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Impact of an Emergency Department Observation Unit Management Algorithm for Atrial Fibrillation"],"prefix":"10.1161","volume":"5","author":[{"given":"Shawna D.","family":"Bellew","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merri L.","family":"Bremer","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen L.","family":"Kopecky","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Lohse","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Munger","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Robelia","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Smars","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.09.013"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.06.005"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.03.007"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.039677"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.958165"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.008201"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.07.005"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12016"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0b013e328359588f"},{"key":"e_1_3_4_11_2","first-page":"CD002903","article-title":"Electrical cardioversion for atrial fibrillation and flutter","volume":"3","author":"Mead GE","year":"2005","unstructured":"Mead GE, Elder AT, Flapan AD, Kelman A. 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