What Should We Do About A-Fib/Flutter when There Is Another Acute Condition?

Rapid atrial fibrillation or flutter (A-fib/flutter) can be managed by rate or rhythm control, but prior studies have focused on A-fib/flutter occurring in isolation. Now, investigators have retrospectively compared the incidence of adverse events in patients with A-fib/flutter and a serious underlying acute condition who either did or did not undergo rate or rhythm control.

During the 1-year study period, 416 patients at two Canadian emergency departments had A-fib/flutter and other complex acute medical issues. Among 135 patients with attempted rate or rhythm control, 41% had adverse events such as hypotension or intubation. Among 281 patients with no attempted rate or rhythm control, 7% had adverse events. The two groups were similar at b…