[Recent onset atrial fibrillation at a unit of internal medicine]

The study is including 239 patients (145 males, 94 females, mean age 68.2 years), with recent-onset atrial fibrillation, hospitalised in a Unit of Internal Medicine. Valvular disease and systemic hypertension were the predominant diseases. Management of patients: clinical observation, electrical shock, antiarrhythmic drug therapy, reduction of heart frequency. Sinus rhythm was restored in 176 patients (74%). Antiarrhythmic drug therapy included propafenone, quinidine and amiodarone. Sinus rhythm was restored by antiarrhythmic drug therapy in 115 of 161 patients (71%); there was no difference of efficacy in antiarrhythmic drugs. Electrical shock restored sinus rhythm in 33 of 38 patients (87%). The following characteristics predicted the restoration of sinus rhythm: absence of valvular disease versus presence of systemic hypertension (p = 0.01), duration of atrial fibrillation < 12 hours (p = 0.02), age > 70 years (p = 0.00001). There were 2 serious complications: 1 stroke, 1 torsade de pointes.