AI Article Synopsis
- The study evaluates how emergency departments manage patients with recent-onset atrial fibrillation or flutter, focusing on safety and effectiveness.
- The research involved 206 patients, with successful cardioversion in 95.7% of those who underwent it, and a majority (88.8%) were discharged home without significant complications.
- The findings suggest that this management approach is both safe and effective, contributing to low rates of adverse events and thromboembolic incidents after 30 days.
Article Abstract
Background: The management of emergency department (ED) patients with presumed recent-onset atrial fibrillation or flutter≤48h in duration varies widely.
Objective And Method: We conducted a prospective study across three affiliated community EDs within a large integrated health care delivery system to describe the management of patients with recent-onset atrial fibrillation or flutter, to determine the safety and effectiveness of ED cardioversion, and to measure the incidence of thromboembolism 30 days after discharge.
Results: We enrolled 206 patients with convenience sampling between June 2005 and November 2007. Mean age was 64.0±14.4 years (range 21-96 years). Patients were grouped for analysis into four categories based on whether cardioversion was 1) spontaneous in the ED (59; 28.6%); 2) attempted with electrical or pharmacological means (115; 56.3%), with success in 110 (95.7%); 3) hoped for during a short stint of home observation (16; 7.8%, 11 of which spontaneously converted to sinus rhythm within 24h); or 4) contraindicated (16; 7.8%). Of the entire group, 183 (88.8%) patients were discharged home. Adverse events requiring ED interventions were reported in 6 (2.9%; 95% confidence interval [CI] 1.1-6.2%) patients, all of whom recovered. Two (1.0%; 95% CI 0.1-3.5%) patients were found to have an embolic event on 30-day follow-up.
Conclusions: Our approach to ED patients with presumed recent-onset atrial fibrillation or flutter seems to be safe and effective, with a high rate of cardioversion and discharge to home coupled with a low ED adverse event and 30-day thromboembolic event rate.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jemermed.2010.05.017 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictive Value of N-Terminal Pro B-Type Natriuretic Peptide for Short-Term Outcome of Cardioversion in Patients with First-Diagnosed or Paroxysmal Atrial Fibrillation Presenting to the Emergency Department.
Biomedicines
December 2024
University Department of Emergency Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
: Atrial fibrillation (AF) is a common arrhythmia in the emergency department (ED). We investigated the role of N-terminal pro b-type natriuretic peptide (NT-proBNP) in predicting both the outcome of AF cardioversion and the risk of AF recurrence or persistence on the 8th (D8) and 30th (D30) day post-cardioversion. : This prospective, observational study evaluated patients with recent-onset AF, managed by either pharmacological (PC) or electrical cardioversion (EC) in the ED.
View Article and Find Full Text PDFTime efficiency and safety of antazoline in the rapid cardioversion of recent onset atrial fibrillation during supraventricular arrhythmias ablation.
Kardiol Pol
January 2025
Department of Cardiology, Medical University of Lodz, Łódź, Poland.
Symptoms Burden as a Clinical Outcomes Assessment in Heart Failure Patients With Atrial Fibrillation.
JACC Heart Fail
November 2024
Division of Cardiology, University of Colorado School Anschutz Medical Campus, Aurora, Colorado, USA; Cardiovascular Institute, University of Colorado School Anschutz Medical Campus, Aurora, Colorado, USA; ARCA Biopharma, Westminster, Colorado, USA. Electronic address:
Background: Safe and effective pharmacologic therapy for atrial fibrillation (AF) in heart failure (HF) is an unmet need. In AF clinical trials, the standard primary endpoint of time to first symptomatic AF event (TTFSE) has several disadvantages, which could theoretically be overcome by measurement of AF-specific symptoms burden during an entire follow-up period.
Objectives: The authors sought to develop and validate a method of measuring symptom burden of AF in a HF population.
[Early measurement of digoxin concentration in blood serum to predict adverse events in older age groups with chronic heart failure and atrial fibrillation.].
Adv Gerontol
November 2024
Saint-Petersburg Institute of Bioregulation and Gerontology, 3 Dinamo pr., St. Petersburg 197110, Russian Federation, e-mail:
To evaluate the effect of early measurement of serum digoxin concentration (SDC) on therapeutical safety and efficacy in patients with recent-onset atrial fibrillation and heart failure. De novo ventricular arrhythmias, high-grade AV node or sinus node blocks were noted in 22%, this risk was positively associated with endpoint SDC (mean SDC 0,88±0,78 ng/mL vs 0,45±0,71 ng/mL, p=0,039) irrespective of baseline characteristics. Empiric calculators for long-term digoxin monitoring correlated with both SDC (r=0,54.
View Article and Find Full Text PDFPrevalence of Cardiac Amyloidosis Among Elderly Patients With Recent-Onset Atrial Fibrillation: The PREVAL-ATTR Study.
Can J Cardiol
October 2024
Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA, Madrid, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Spain. Electronic address:
Article Synopsis
- Transthyretin cardiac amyloidosis (ATTR-CA) is a treatable form of heart failure, often associated with atrial fibrillation (AF), and the study explores if recent-onset AF can indicate ATTR-CA in patients over 65.
- In a study of 121 patients recently diagnosed with nonvalvular AF, 10 were found to have cardiac amyloidosis, with notable differences in age, sex, and heart metrics observed between those with and without the condition.
- The findings suggest that routine screening for ATTR-CA using echocardiography and other tests may benefit older patients with AF and specific heart features, although more extensive research is needed to confirm these results in varied clinical situations.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!