Renal Insufficiency Is Associated with Worse Outcomes in Atrial Fibrillation or Flutter

Emergency department (ED) patients with atrial fibrillation or flutter (AF) and certain comorbidities are at higher risk for adverse events from attempts at rate or rhythm control (NEJM JW Emerg Med Feb 2015 and Ann Emerg Med 2015; 65:511). To elucidate how renal insufficiency may contribute to such adverse events, researchers performed a chart review of patients with electrocardiography-confirmed AF in two Canadian EDs in 2009. They compared 412 patients with estimated glomerular filtration rate (eGFR) <60 mL/minute/1.73 m² and 700 with eGFR ≥ 60 mL/minute. Predefined adverse events included hypotension, airway intervention, thromboembolic events, and death.

Patients with renal insufficiency were older, had more other comorbidities, and suf…