New onset atrial fibrillation – optimising electrocardiographic diagnostic accuracy and appropriate anticoagulation: a district general hospital experience

included multiple teaching sessions in departmental meetings, circulation of posters around the hospital, and liaising with the pharmacy department to validate the prescribed dose of anticoagulation.A recommendation was made for the need for the involvement of two independent clinicians in the decision-making for the accurate diagnosis of atrial fibrillation or specialist involvement, if uncertain.In the second cycle, we included the same number of patients and used similar comparative parameters.Only four patients (8%) were misdiagnosed with atrial fibrillation and none of them (0%) were inappropriately anticoagulated or prescribed the wrong dose of anticoagulation.This reduction in misdiagnosis and inappropriate or incorrectly dosed anticoagulation was related to the use of a more cautious approach by clinicians when confirming the diagnosis of NOAF and deciding to commence anticoagulation. ConclusionIncreased awareness among physicians of the need for diagnostic accuracy of NOAF and appropriate anticoagulation has resulted in significant improvements that have led to the minimisation of potential harm to patients and improved safety standards.We aim to use these data to help develop a cardiac arrhythmia service at our hospital, which will further improve the diagnosis and management of NOAF and other arrhythmias.