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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, October 21, 2019

Acute Uncomplicated AF

R.E.B.E.L.EM - October 21, 2019 - By Mark Ramzy
..."Clinical Question:
Does the use of a chemical-first or electrical-first cardioversion strategy of uncomplicated AF result in achievement of sinus rhythm and discharge more quickly?
Author’s Conclusions:
In uncomplicated ED patients with atrial fibrillation, chemical-first and electrical first strategies appear to be successful and well tolerated. An electrical-first strategy results in significantly shorter ED length of stay.
Our Conclusion:
The question of rate or rhythm controlling uncomplicated atrial fibrillation patients in the ED continues to be a topic of debate. Despite its small sample size, this study helps add to our current body of knowledge and opens the discussion on which of the two cardioversion strategies is faster for sending the patient home. It also sets the stage for a larger study to be repeated, where these findings can be validated and confirmed.
Clinical Bottom Line:
When treating acute uncomplicated atrial fibrillation patients in the ED, emergency physicians can consider either an electrical-first or chemical-first strategy of cardioversion. Although small, this study suggests that an electrical-first approach may expedite the patient’s disposition, further research is needed to confirm this."