The articles were grouped into four main categories : decision aids and outcome predictors , electrical cardioversion-based protocol s , antiarrhythmic-based protocol s , and general management protocol s. Conclusion This systematic review is the first study to our knowledge to evaluate the optimal management of symptomatic AF/AFLin  the ED with a direct impact on ED disposition .
There are several viable management strategies that can result in safe discharge from the ED in the right patient population , and decision aids can be utilized to guide selection of appropriate patients for discharge
Introduction Management of  atrial fibrillation ( AF ) and atrial flutter ( AFL )  in the emergency department ( ED ) varies greatly , and there are currently no United States guidelines to guide management with regard to patient disposition after ED treatment .
The aim of this systematic review was to evaluate the literature for decision aids to guide disposition of patients with AF/AFLin the ED , and assess potential outcomes associated with different management strategies in the ED .
An emergency department observation unit protocol for acute-onset atrial fibrillation is feasible.
STUDY OBJECTIVE 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 ) .  METHODS This descriptive case series took place at a major suburban , university-affiliated teaching hospital . Patients were prospect ively 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 . RESULTS 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 infa rct ion , 2 for fever , and 1 for ventricular tachycardia . Twelve ( 18 % ) patients remained in atrial fibrillation , with 9 admitted and 3 discharged . Overall , 81 % of patients were discharged in 11.8+/-7.0 hours , and 19 % were admitted after 17.6+/-9.5 hours of observation . Three discharged patients returned within 7 days , 2 for uncomplicated recurrent AAF and 1 for chest pain subsequently found to be noncardiac in origin . There were no major complications attributable to the EDOU protocol . CONCLUSION Selected patients with AAF for whom initial ED management fails can subsequently be managed in an EDOU with a high short-term conversion and discharge rate
The articles were grouped into four main categories : decision aids and outcome predictors , electrical cardioversion-based protocol s , antiarrhythmic-based protocol s , and general management protocol s. Conclusion This systematic review is the first study to our knowledge to evaluate the optimal management of symptomatic AF/AFLin  the ED with a direct impact on ED disposition .
There are several viable management strategies that can result in safe discharge from the ED in the right patient population , and decision aids can be utilized to guide selection of appropriate patients for discharge
Introduction Management of  atrial fibrillation ( AF ) and atrial flutter ( AFL )  in the emergency department ( ED ) varies greatly , and there are currently no United States guidelines to guide management with regard to patient disposition after ED treatment .
The aim of this systematic review was to evaluate the literature for decision aids to guide disposition of patients with AF/AFLin the ED , and assess potential outcomes associated with different management strategies in the ED .