PMID: 22575297May 12, 2012Paper

Use of rate control medication before cardioversion of recent-onset atrial fibrillation or flutter in the emergency department is associated with reduced success rates

CJEM
Gabriel E BlecherGeorge A Wells

Abstract

It is believed that when patients present to the emergency department (ED) with recent-onset atrial fibrillation or flutter (RAFF), controlling the ventricular rate before cardioversion improves the success rate. We evaluated the influence of rate control medication and other variables on the success of cardioversion. This secondary analysis of a medical records review comprised 1,068 patients with RAFF who presented to eight Canadian EDs over 12 months. Univariate analysis was performed to find associations between predictors of conversion to sinus rhythm including use of rate control, rhythm control, and other variables. Predictive variables were incorporated into the multivariate model to calculate adjusted odds ratios (ORs) associated with successful cardioversion. A total of 634 patients underwent attempted cardioversion: 428 electrical, 354 chemical, and 148 both. Adjusted ORs for factors associated with successful electrical cardioversion were use of rate control medication, 0.39 (95% confidence interval [CI] 0.21-0.74); rhythm control medication, 0.28 (95% CI 0.15-0.53); and CHADS₂ score > 0, 0.43 (95% CI 0.15-0.83). ORs for factors associated with successful chemical cardioversion were use of rate control medication, 1...Continue Reading

References

Apr 16, 2003·Archives of Internal Medicine·Luz M LetelierGordon H Guyatt
Jun 25, 2005·American Heart Journal·Vincent E HagensUNKNOWN RAte Control versus Electrical cardioversion for persistent atrial fibrillation study group
Jun 21, 2008·The New England Journal of Medicine·Denis RoyUNKNOWN Atrial Fibrillation and Congestive Heart Failure Investigators
Aug 8, 2009·Pacing and Clinical Electrophysiology : PACE·James A Reiffel

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Citations

Dec 24, 2014·Pacing and Clinical Electrophysiology : PACE·Toni GrönbergK E Juhani Airaksinen

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