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Published on: February 26, 2013
Atrial fibrillation: management strategies in the emergency department
1Department of Emergency Medicine, Weill Medical College of Cornell University, The Brooklyn Hospital Center, Brooklyn, NY, USA.
Insights
Atrial fibrillation and flutter are common, increasing with age. This review offers evidence-based strategies for diagnosing and managing these arrhythmias, including anticoagulation and novel agents.
Area of Science:
- Cardiology
- Emergency Medicine
Background:
- Atrial fibrillation and atrial flutter are prevalent cardiac arrhythmias.
- The aging population is driving an increase in cases, impacting emergency departments.
- Complications include heart failure and thromboembolic disease, necessitating effective management.
Purpose of the Study:
- To review recent literature on the diagnosis and management of atrial fibrillation.
- To provide evidence-based recommendations for emergency department care.
- To address cost-effective evaluation and treatment strategies.
Main Methods:
- Literature review of recent studies on atrial fibrillation diagnosis and management.
- Analysis of evidence for various treatment strategies.
- Synthesis of recommendations for clinical practice.
Main Results:
- Identification of key diagnostic and management approaches for new-onset arrhythmias.
- Evaluation of rate control strategies and cardioversion efficacy.
- Guidance on anticoagulation indications and novel agent use.
Conclusions:
- Effective diagnosis and management of atrial fibrillation are crucial, especially in an aging population.
- Evidence-based strategies improve patient outcomes and resource utilization.
- Novel anticoagulants offer new therapeutic options for stroke prevention.
Abstract:
Atrial fibrillation and atrial flutter are the most common dysrhythmias seen in the emergency department. As the aging population continues to grow, atrial fibrillation and atrial flutter are expected to affect 6 million people by 2050. This will lead to an increase in emergency department visits for symptoms from the disease itself or its complications, such as heart failure or thromboembolic disease. This review examines the recent literature on the diagnosis and management of atrial fibrillation. Evidence-based recommendations are provided, including cost-effective strategies to evaluate new-onset arrhythmias and unstable patients with atrial fibrillation, rate control strategies, the use of medical and direct current cardioversion for new-onset atrial fibrillation/atrial flutter, whom and when to anticoagulate, and the use of the novel anticoagulation agents.
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