An emergency department observation unit protocol for acute-onset atrial fibrillation is feasible

Annals of Emergency Medicine
Benjamin O KoenigRaymond E Jackson

Abstract

We sought to describe the feasibility of an emergency department observation unit (EDOU) treatment protocol for the management of uncomplicated acute-onset atrial fibrillation (AAF). This descriptive case series took place at a major suburban, university-affiliated teaching hospital. Patients were prospectively enrolled in an EDOU treatment protocol if they had uncomplicated AAF that failed initial ED attempts to convert to sinus rhythm. In the EDOU, patients underwent ECG monitoring, serial creatine kianse MB measurements, and further rate control with optional electrical cardioversion. Primary outcomes measured were EDOU rate of conversion to sinus rhythm, rate of discharge home, length of stay, positive diagnostic outcomes, complications of AAF, and 7-day return visits. Sixty-seven patients were studied. Patients were symptomatic for a median of 4.0 hours, had mean initial ED pulse rates of 137+/-23 beats/min, and spent 4.7+/-2.2 hours in the ED before transfer to the EDOU. While in the EDOU, 55 (82%) patients converted to sinus rhythm. Five (7%) patients were admitted because of positive test results: 2 for myocardial infarction, 2 for fever, and 1 for ventricular tachycardia. Twelve (18%) patients remained in atrial fibril...Continue Reading

Citations

Mar 15, 2008·Critical Pathways in Cardiology·Michael A RossAmy Dresselhouse
Apr 8, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Frank Xavier ScheuermeyerMaziar Sighary
Jul 25, 2012·Critical Pathways in Cardiology·Michael A RossCarol Clark
Dec 7, 2011·Emergency Medicine International·Brian Doyle, Mark Reeves
Oct 26, 2018·Advanced Science·Mehdi MehraliAlireza Dolatshahi-Pirouz
Feb 10, 2016·Journal of the American Heart Association·Shawna D BellewPeter A Smars
Mar 10, 2005·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Soheil Zahir, Philippe Lheureux
Oct 3, 2006·Scandinavian Cardiovascular Journal : SCJ·Hanna Kyhälä-ValtonenLiisa-Maria Voipio-Pulkki
Oct 25, 2012·Internal and Emergency Medicine·Andrea TampieriTiziano Lenzi
Mar 11, 2018·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher W BaughJesse M Pines
Jul 26, 2011·International Journal of Emergency Medicine·C James HollimanKathleen Clem
Mar 23, 2013·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Frank Xavier ScheuermeyerGrant Innes
Jul 17, 2010·The Journal of Emergency Medicine·David R VinsonTerry M Williams

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