The goal of this provincial initiative is to improve access to care for patients living with this rhythm disorder. Nurse and Pharmacist Clinicians use a telephone-based service (virtual presence), and specialized cardiologists (located at Pulse Complete Cardiac Care) facilitate both telephone and in-person visits, that aim to provide education and medical management strategies to improve the quality of life for people experiencing atrial fibrillation (AF) and/or atrial flutter (AFL).
Read the AFC Mission Statement.
We do this through:
People experiencing atrial fibrillation and/or atrial flutter, who reside on Vancouver Island or surrounding communities. Our education videos are available for anyone who is interested to learn more about atrial fibrillation and atrial flutter.
Patients awaiting consultation from one of our clinic cardiologists are required to watch the first two sections to ensure they are well informed for their visit.
Please watch this education video about atrial fibrillation (AF) and atrial flutter (AFL) before attending any clinician appointments for AF/AFL management.
Learn about lifestyle interventions you can make to slow the progression of atrial fibrillation (AF).
Patients awaiting consultation from one of our clinic cardiologists are required to watch the video below to ensure they are well informed for their visit.
See the modifiable risk factors for atrial fibrillation.
Management options for modifiable risk factors:
Image from: Canadian Journal of Cardiology 2020 361847-1948DOI: (10.1016/j.cjca.2020.09.001).
Learn more about:
Download this helpful home blood pressure log.
Learn more about the importance of exercise in managing AF from the video below:
Anxiety and stress can be a symptom of atrial arrhythmia as well as a possible acute trigger for atrial fibrillation.
In addition to support from your primary care provider, the following self-help resources may aid you to further reduce anxiety and stress:
We recommend that you watch the general education videos in the above sections of this page first as the following medication videos will refer to medical terms and discuss concepts that were explained in the prior videos.
Stroke caused by atrial fibrillation (AF) is highly preventable when treated appropriately with anticoagulants.
DOACs, or “Direct-acting Oral Anti-Coagulants, are often recommended first line when anticoagulation is indicated in AF.
Four DOACs are currently approved for use in Canada: apixaban, dabigatran, edoxaban, and rivaroxaban. Learn more in this video:
Warfarin may be considered for anticoagulation in cases where DOACs cannot be used; for example, in AF patients with mechanical heart valves or rheumatic valve disease.
Learn more in the following video:
Rate control ensures that the heart does not beat too quickly with atrial fibrillation (AF).
Medications can be used to slow a fast heart rate, thereby lessening symptoms as well as the risks for certain other heart-related complications.
Examples include:
Note: common beta blockers include: metoprolol, bisoprolol & carvedilol
Rhythm control means trying to get the heart back to a normal rhythm and then help keep it there. Medications known as anti-arrhythmic agents are one way to re-establish a normal rhythm.
These medications are not for everyone and should first be prescribed by an appropriate specialist (e.g. internist or cardiologist).
We recommend that you first view the introductory education found in the above section of this page (learn about atrial fibrillation and atrial flutter – required viewing for AFC patients) as the following videos use medical terminology and build upon concepts discussed in that section.
Cardioversion – English, Farsi, Traditional Chinese, Simplified Chinese, or Punjabi
Ablation for atrial fibrillation – English, Farsi, Traditional Chinese, Simplified Chinese, or Punjabi
Ablation for atrial flutter – English, Farsi, Traditional Chinese, Simplified Chinese, or Punjabi
Ablation for atrioventricular node – English, Farsi, Traditional Chinese, Simplified Chinese, or Punjabi
Pacemaker – English, Farsi, Traditional Chinese, Simplified Chinese, or Punjabi
Recovering for ablation for atrial fibrillation – English
Referral to the AFC may not be necessary if:
If your patient has a BMI > 35, then consider a referral to a metabolic clinic as weight loss > 10% resulted in a 6 fold greater probability of arrhythmia free survival and 45.5% of such patients in the LEGACY trial no longer needed anti-arrhythmic therapy or ablation.
Site specific referrals can be downloaded for:
If your patient consumes >21 alcoholic beverages per week and has not been able to abstain or minimize their use upon clinician request, then consider referral to a support program as indicated since appropriate lifestyle interventions may be sufficient for maintaining regular rhythm.
See the Rapid Access Addiction Clinic and referral form.
If your patient has been recently identified as having untreated hyperthyroidism, then please refer to an endocrinologist for management as this remains an important treatable cause of AF. Be aware that the Canadian Cardiovascular Society suggested in 2020 that “most patients with secondary AF due to thyrotoxicosis be anticoagulated until a euthyroid state is restored.” This is an independent risk factor for thromboembolic events regardless of CHAD-65 scoring.
When to refer to the AFC?
If your patient does not meet the AFC eligibility requirements in the referral form and you would still like your patient to receive a cardiology consultation within the South Island region, then:
If you would like to learn more about monitoring rhythm or rate control therapy while awaiting EP consultation, then please see the following CSBC algorithms:
Phone: 250-370-8632
Fax: 250-519-1893
Mailing Address Only:
Royal Jubilee Hospital
Royal Block- 3rd Floor, Room 343
1952 Bay St
Victoria, B.C.
V8R 1J8
Clinic Cardiologist offices are located at PULSE Complete Cardiac Care
#300 – 3680 Uptown Blvd
Uptown Shopping Centre
Victoria, B.C.
V8Z 0B9
Phone: 250-595-1551
Fax: 250-595-1000
