Emergency department management of atrial fibrillation in canada, where cardioversion is typical – nejm journal watch

Emergency department management of atrial fibrillation in canada, where cardioversion is typical - nejm journal watch pharmacologic cardioversion

For atrial fibrillation or flutter with onset within 48 hrs, the tide continues to be turning recently from rate control to rhythm control. Canadian investigators conducted a potential cohort study to find out 30-day outcomes among patients treated for atrial fibrillation or flutter in six academic emergency departments (EDs). The composite results of adverse occasions incorporated dying, stroke, acute coronary syndrome, heart failure, subsequent admission for atrial fibrillation or flutter, and subsequent Erectile dysfunction electrocardioversion.

Of 1091 patients enrolled (mean age, 64 years), 85% had atrial fibrillation and 15% had flutter. Electrical or pharmacologic cardioversion was utilized in 73% of patients, 9% were accepted, and 80% transformed into sinus rhythm within the Erectile dysfunction (regardless of disposition). Within thirty days, 10.5% of patients had adverse occasions, but there have been no deaths associated with atrial fibrillation or flutter. Adverse occasions were considerably not as likely among patients who achieved sinus rhythm (proportions weren’t presented within the paper). On multivariable analysis, other predictors of adverse occasions incorporated time from start of arrhythmia (odds ratio, 1.03 each hour), good reputation for stroke or transient ischemic attack (OR, 2.1), and lung congestion on chest x-ray (OR, 7.4). There is one stroke, which happened 23 days following the index Erectile dysfunction visit inside a patient who’d transformed into sinus rhythm spontaneously within the Erectile dysfunction. Of patients having a CHADS2 score 鈮1, only 49% were on anticoagulants during the day 30.

Resourse: http://jwatch.org/na43361/2017/02/03/

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Video COMMENTS:

medic2807: Remember to assess your patient's level of consciousness and hemodynamics to assess for mechanical capture. you may have electrical capture. I teach my students to turn the mA up while feeling a pulse. when you feel the pulse, stop.锘

Fernando Cardona steadysword: we need more of this videos, thx锘

nanniss76: Muchas gracias !!!锘

romanking: thanks a lot for this illustration..锘

Francisco Torano: Taking my oral boards this weekend and this was a great review, thanks!锘

vinicius teixeira: very good锘

Incazteco: awesome video锘