Must antidysrhythmic agents be given to all patients with new-onset atrial fibrillation?


Ergene U., Ergene O., Fowler J., Kinay O., Cete Y., Oktay C., ...More

AMERICAN JOURNAL OF EMERGENCY MEDICINE, vol.17, no.7, pp.659-662, 1999 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 17 Issue: 7
  • Publication Date: 1999
  • Doi Number: 10.1016/s0735-6757(99)90153-5
  • Journal Name: AMERICAN JOURNAL OF EMERGENCY MEDICINE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.659-662
  • Keywords: atrial fibrillation, cardioversion, spontaneous conversion, propafenone, ORAL PROPAFENONE, CARDIOVERSION, CONVERSION, THERAPY
  • Dokuz Eylül University Affiliated: No

Abstract

We investigated the spontaneous conversion rate of new-onset atrial fibrillation (AF) in emergency department patients and the recurrence rate of AF during al month follow up period. Sixty-six consecutive hemodynamically stable patients presenting to a university hospital emergency department with new-onset atrial fibrillation (less than 72 hours duration) comprised the study population. Patients were initially monitored for 8 hours and observed for spontaneous conversion of AF to sinus rhythm. If conversion did not occur in the first 8 hours, an oral loading dose (600 mg) of propafenone was given, and patients were observed for an additional 8 hours. All patients were reevaluated at 24 hours and at 1 month, The spontaneous conversion rate in patients presenting within 6 hours of AF onset during the initial 8-hour observation period was 71%. The spontaneous conversion rate for ail patients during the initial observation period was 53%, The conversion rates between patients presenting "early" (less than 6 hours) and "late" (7-72 hours) were significantly different (P < 0.001). Many patients with new-onset AF, especially those with atrial fibrillation duration less than 6 hours, may need observation only, rather than immediate intervention, to treat their dysrhythmia, (Am J Emerg Med 1999;17:659-662. Copyright (C) 1999 by W.B. Saunders Company).