TY - JOUR
T1 - Is emergency department cardioversion of recent-onset atrial fibrillation safe and effective?
AU - Cohn, Brian G.
AU - Keim, Samuel M.
AU - Yealy, Donald M.
PY - 2013/7
Y1 - 2013/7
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Cardioversion
KW - Effectiveness
KW - Emergency Department
KW - Recent onset
UR - http://www.scopus.com/inward/record.url?scp=84897357034&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2013.01.027
DO - 10.1016/j.jemermed.2013.01.027
M3 - Article
C2 - 23643237
AN - SCOPUS:84897357034
VL - 45
SP - 117
EP - 127
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
SN - 0736-4679
IS - 1
ER -