Abstract
Background
Atrial fibrillation (AF) is a very common dysrhythmia presenting to Emergency Departments
(EDs). Controversy exists regarding the optimal clinical therapy for these patients,
which typically focuses on rhythm rate-control and admission or cardioversion and
discharge home.
Clinical Question
Is ED cardioversion of recent-onset atrial fibrillation safe, effective, and does
it result in positive meaningful patient outcomes?
Evidence Review
Five observation studies with nearly 1600 ED patients with atrial fibrillation treated
with either rate-control or cardioversion were reviewed and results compiled.
Results
Overall, ED cardioversion for recent-onset AF seems safe and effective, with success
rates ranging from 85.5% to 97% in these studies. Although further research should
seek to identify patients at low risk for thromboembolic complication, more rigorously
assess patient satisfaction, and show cost savings, emergency physicians should feel
comfortable using this approach in select patients.
Conclusion
ED cardioversion for recent-onset AF seems safe and effective.
Keywords
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Article info
Publication history
Published online: May 02, 2013
Accepted:
January 24,
2013
Received:
November 5,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
