Beton, Osman Cumhuriyet University - School of Medicine - Department of Cardiology, Turkey , Yılmaz, Mehmet Birhan Cumhuriyet University - School of Medicine - Department of Cardiology, Turkey , Korkmaz, Özge Cumhuriyet University - School of Medicine - Department of Cardiovascular Surgery, Turkey , Berkan, Öcal Cumhuriyet University - School of Medicine - Department of Cardiovascular Surgery, Turkey , Tandoğan, İzzet Cumhuriyet University - School of Medicine - Department of Cardiology, Turkey

Cardioversion of recent-onset atrial fibrillation and flutter in the emergency department

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Atrial fibrillation (AF) is the most common arrhythmia encountered in acute medical practice. One-third of hospitalizations for cardiac rhythm disturbances are attributed to AF, with increasing rates in the past decade. Significant morbidity and mortality, including 15% to 20% of all ischemic strokes and 20% of all strokes, result from AF. The overall mortality rate for patients with AF is approximately double that for patients in normal sinus rhythm. Atrial flutter (AFL) has many clinical aspects that are similar to AF, AF and AFL have same management strategies in emergency settings. The major goals of treatment include alleviation of the associated symptoms and/or hemodynamic disturbance, reduction of the risk of systemic thromboembolism, reduction in hospital length of stay. The very large scaled AFFIRM and AF-CHF clinical trials compared rate and rhythm control (cardioversion), but did not explore the optimal management for recent-onset AF/AFL patients presenting to the emergency department (ED) with in 48 hours of symptoms. Although international standard guidelines are available, AF treatment in ED is still heterogeneous in terms of the management strategy (rate or rhythm) chosen. National based guidelines or consensus documents specific to ED management of AF has recently been developed and published in order to solve this problem. Aim of this review is to give detailed information for ED team about echocardiographic criterias supporting cardioversion (CV) of AF, CV procedure itself and new antiarrhythmic and oral anticoagulant drugs by adhering to the guidelines.

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Cardioversion , recent , onset atrial fibrillation , flutter , emergency

Cumhuriyet Medical Journal

309