ed patients 18 years and older

provide informed consent

have a documented diagnosis of af or atrial flutter on electrocardiogram or rhythm strip from an ed, prehospital provider or outside medical facility on day of enrollment.

present with signs (tachycardia, dyspnea) or symptoms (palpitations, chest pain, shortness of breath, weakness, lightheadedness, pre-syncope, or syncope) consistent with primary symptomatic af

patients whose primary complaint is not directly related to their af diagnosis (e.g. evaluation for febrile illness, gastrointestinal complaint, injury) but have a secondary complaint consistent with symptomatic af that requires ed evaluation (e.g. new af diagnosis, af associated with inadequate rate control (defined as resting heart rate greater than 100bon), af associated with heart failure symptoms, af in the setting of cva or tia, af associated with other thromboembolic complications).

patients who are under the age of 18

previously enrolled patients

ed patients who present with complaints unrelated to their af (e.g. sprained ankle,pharyngitis) and have adequately rate (<100 bpm at rest) or rhythm controlled-af.