Rapid Treatment and Discharge of Patients with Recent-Onset Atrial Fibrillation or Flutter

Rapid cardioversion and discharge home is safe for emergency department patients who present within 48 hours of onset of atrial fibrillation or flutter.

Researchers evaluated the efficacy and safety of a protocol for rapid emergency department (ED) cardioversion and discharge of patients with recent-onset (<48 hours) atrial fibrillation or atrial flutter in a retrospective observational study of 660 consecutive patients (95% with atrial fibrillation, 5% with atrial flutter) at a single ED in Canada from 2000 to 2005. The protocol involved ED pharmacologic cardioversion with intravenous (IV) procainamide (1 g during 60 minutes) and, if needed, electrical cardioversion, followed by discharge home within 1 hour after cardioversion.

Sixty percent of patients with atrial fibrillation and 28% of those with atrial flutter converted to sinus rhythm with IV procainamide. Electrical cardioversion (not…

Reviewing Author

Kristi L. Koenig, MD, FACEP

Disclosures

Editorial boardsKoenig & Schultz's Disaster Medicine: Comprehensive Principles and Practices

Kristi L. Koenig, MD, FACEP

Disclosures

Editorial boardsKoenig & Schultz's Disaster Medicine: Comprehensive Principles and Practices