Innovative primary care lead community palpitation management and investigation pathway

Abstract Funding Acknowledgements Type of funding sources: None. Background Palpitations are a common reason for General Practitioner (GP) appointment in primary care and frequent cardiology referral. In the region where this project was performed, translated to approximately 24,000 out hours consultations 2021 alone. Purpose The purpose pilot evaluate pathway palpitations diagnosis management care. proposed designed avoid unnecessary referrals secondary care, shorten waiting time patients cut down visits A&E service Method pathway, which piloted at federation 30,000 patients, based on community approach, GP with Special interest could offer wider community. began an initial clinical evaluation comprising medical history, physical examination, standard 12-lead ECG. After ruling any red flags otherwise deemed appropriate continue be assessed diagnostic method, were provided handheld ECG device intermittent 30 seconds registration home. During four-week investigation period would record their when experiencing symptoms. team remotely monitored traces received cloud-based system AI capabilities, if pathology recorded, patient contacted informed plan. If after four weeks no found, discharge consultation reassurance final report generated. Results 24-month we screened total 191 patients. Out 24 (13%) diagnosed atrial fibrillation, 92 (48%) benign ectopics as cause palpitations. Two rare occurrences life threatening broad complex tachycardias also detected, both ended up needing defib implantation. Table 1. further presents results by rest Conclusions from indicated reduction / 50% over 90% referral Holter monitoring implementing easy-to-use part led palpitation pathway. implied that district-wide implementation lead least 120 new AF our district per year, having knock-on benefit stroke cost economic impact society reducing anxiety, lost employment increasing productivity. Another key outcome seen is value conducting symptomatic reassure majority whom had either normal sinus rhythm or ventricular failed satisfied conventional past.