Telehealth Clinics May Safely Manage Low-Risk Atrial Fibrillation Patients: Study
Written By : Medha Baranwal
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2026-08-11 14:45 GMT | Update On 2026-08-11 14:45 GMT
Australia: A pilot study published in the BMJ journal Heart suggests that selected low-risk patients with acute atrial fibrillation (AF) could be safely managed in the community using telehealth and rapid-access clinics, potentially avoiding emergency department visits. The model appeared feasible, ensured faster specialist input, and reduced hospital burden, though larger studies are needed to confirm long-term safety and scalability.
The STAY (Safe Treatment of Atrial Fibrillation in the CommunitY) pilot, led by Jocasta Ball and colleagues from Monash University, tested whether low-risk AF cases could be managed outside hospital settings through an integrated pathway involving paramedics, cardiologists, and virtual care.
Adults aged ≥18 years presenting with acute AF were first assessed by paramedics using clinical evaluation and ECG. Eligibility was confirmed by cardiologist review, and only low-risk patients—without hemodynamic instability or recent bleeding risk—were included. Enrolled patients received early treatment when indicated and were routed to telehealth consultations or rapid-access AF clinics instead of emergency department transfer.
The following were the key findings:
- Out of 573 patients with atrial fibrillation assessed, 445 were classified as low risk.
- A total of 57 patients were enrolled in the STAY community-based care pathway.
- Paramedics administered metoprolol in just over 50% of cases.
- Rivaroxaban was given in approximately 40% of patients, with no immediate safety concerns reported.
- Patients were subsequently managed through video-based telehealth consultations or dedicated AF clinics.
- The average time to initial specialist assessment was just over one day.
- The average wait time for AF clinic review was around three days.
- A total of 41 patients received virtual telehealth consultations.
- 55 patients attended outpatient atrial fibrillation clinics.
- No deaths were reported within 30 days of follow-up.
- Only three patients (around 5%) required hospital admission during the 30-day follow-up period.
- Overall, most low-risk patients were successfully managed in the community without need for hospital escalation.
The study suggests that a structured, community-based model for managing atrial fibrillation can reduce emergency department dependence while maintaining safety in carefully selected low-risk patients. The STAY pathway highlights the value of integrating paramedic assessment, telehealth consultations, and rapid-access specialist care to streamline acute AF management.
However, the authors noted that these findings are based on a pilot study with a limited sample size. They emphasized the need for larger, well-controlled trials to confirm clinical effectiveness, evaluate cost-effectiveness, and assess feasibility for broader implementation across diverse healthcare systems.
The researchers stated that the STAY model shows promise for safely managing selected low-risk patients with acute atrial fibrillation outside hospital settings, but further evidence is needed before it can be adopted into routine clinical practice.
Reference:
Ball J, Nehme Z, Wong G, et alSafe treatment of atrial fibrillation in the community (STAY): a pilot study of community-based care for low-risk patients with acute atrial fibrillation. Heart Published Online First: 14 May 2026. doi: 10.1136/heartjnl-2025-327605
Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.