Atrial fibrillation (AFib) is the most common sustained heart rhythm problem worldwide, with one in three patients over the age of 35 developing AFib at some point in their lives. While not a life-threatening rhythm on its own, AFib can lead to complications including blood clots and strokes, which have high morbidity and mortality. Even without strokes, the condition can cause fluid buildup from heart failure or weaken the heart muscle over time.

A new clinic in Morrisville offers rapid access to prevent strokes, initiate rate and rhythm control, and expedite workup for patients with AFib. Directed by electrophysiologist Sean Pokorney, MD, MBA, the Atrial Fibrillation Access Clinic at Duke Cardiology Arringdon helps patients receive targeted care without ED visits and potential hospitalizations. “If patients are sent to a rapid access clinic, we are highly likely to be able to avoid hospitalizations and emergency department visits,” says Pokorney. “We can manage these patients effectively and efficiently in the outpatient setting.”

Referring to the acute AFib access clinic gives patients faster access to specialized, continuous care. “For new patients, we can help educate them about the condition, treatments, and when to seek emergent care,” says Pokorney. The clinic offers expedited access to imaging and other diagnostic services within cardiology including same-day echocardiograms for outpatients.

For patients with recurrent AFib, rapid care may be even more critical. “For recurrent patients, we try to identify any AFib triggers,” says cardiology nurse practitioner Briana N. Burrow, DNP, who works with the clinic. “We can see if we want to use a different rhythm control strategy to more permanently address future episodes with a procedure or better medication strategy.”

Pokorney and Burrow recommend referring patients who meet any of the following criteria:

• Newly diagnosed atrial fibrillation patients
• Patients hospitalized with a primary diagnosis of atrial fibrillation
• Patients whose pacemakers or defibrillators have detected atrial fibrillation
• Patients experiencing a recurrence of atrial fibrillation after ablation
• Patients with atrial fibrillation and a rapid ventricular response

Referring a patient allows optimization of cardiovascular care. “We can provide continuity of care across all of a patient’s cardiovascular needs, from AFib to more advanced disease states, including advanced heart failure therapies,” says Pokorney. Duke’s advanced heart failure program led the country in volumes in 2024 with 88 durable ventricular assist devices and 132 heart transplants and excellent outcomes.