• Nazanin Meshkat, Emily Austin, Rahim Moineddin, Hamidreza Hatamabadi, Behzad Hassani, Ali Abdalvand, and Amanda Marcuzzi.
• Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Canada. nmeshkat@rogers.com.
• Int J Emerg Med. 2011 Jun 8; 4 (1): 25.

BackgroundThere are few recommendations about the use of cardiac markers in the investigation and management of atrial fibrillation/flutter. Currently, it is unknown how many patients with atrial fibrillation/flutter undergo troponin testing, and how positive troponin results are managed in the emergency department. We sought to look at the emergency department troponin utilization patterns.MethodsWe performed a retrospective chart review of patients with atrial fibrillation/flutter presenting to the emergency department at three centers. Outcome measures included the rates of troponins ordered by emergency doctors, number of positive troponins, and those with positive troponins treated as acute coronary syndrome (ACS) by consulting services.ResultsFour hundred fifty-one charts were reviewed. A total of 388 (86%) of the patients had troponins ordered, 13.7% had positive results, and 4.9% were treated for ACS.ConclusionsTroponin tests are ordered in a high percentage of patients with atrial fibrillation/flutter presenting to emergency departments. Five percent of our total patient cohort was diagnosed as having acute coronary syndrome by consulting services.

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