A 76-year-old female presented with recurrent episodes of paroxysmal atrial fibrillation (AF) , each resulting in emergency department (ED) admissions and successful pharmacological cardioversion to sinus rhythm. Despite multiple hospitalizations between June and September 2023, the patient was discharged without recommendations for further ambulatory diagnostics. She reported daily palpitations, visual disturbances, and weakness.  PMH included diabetes, hypertension, CKD, asthma, heart failure. For prompt diagnostic workup coordinated care model was implementedFollowing persistent symptoms, ambulatory Holter ECG  was performed, revealing continuous AF with a ventricular rate of approximately 115/min, episodes of atrial flutter with 2:1 conduction, and transient bradycardia with a pause of 3.1 seconds. After a brief bradycardic episode, spontaneous conversion to sinus rhythm occurred, with rare ventricular and supraventricular ectopy. The patient was urgently referred to the cardiology department, where a pacemaker was implanted (lead positioned near the left bundle branch).This case highlights the diagnostic and therapeutic challenges in elderly patients with paroxysmal AF and sick sinus syndrome, particularly in the context of multiple comorbidities. It demonstrates the value of coordinated care in expediting access to advanced diagnostics and interventions, which may otherwise be delayed in standard outpatient pathways.The case underscores the importance of comprehensive ambulatory monitoring and coordinated care in patients with recurrent arrhythmias and syncope. Early identification of conduction disturbances and timely intervention can prevent further complications and improve quality of life. The experience advocates for broader implementation of coordinated care models in primary care settingsDespite repeated ED visits, the patient’s arrhythmia was not fully evaluated until coordinated care facilitated Holter monitoring and specialist referral. The findings led to the diagnosis of sick sinus syndrome and the need for pacemaker implantation. The case illustrates the limitations of episodic care and the benefits of integrated, patient-centered approaches in managing complex cardiac patients.Coordinated care enabled prompt diagnosis and effective treatment of paroxysmal AF and sick sinus syndrome in an elderly patient with multiple comorbidities. This approach shortened the diagnostic process and improved clinical outcomes, highlighting the need for integrated care pathways in the management of complex arrhythmia cases.