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 .
Emergency department use of intravenous procainamide for patients with acute atrial fibrillation or flutter.
OBJECTIVES Acute atrial fibrillation and flutter are very common arrhythmias seen in emergency department ( ED ) patients , but there is no consensus for their optimal management . The objective of this study was to examine the efficacy and safety of intravenous ( IV ) procainamide for acute atrial fibrillation or flutter . METHODS This health records review included a consecutive cohort of ED patients with acute-onset atrial fibrillation or atrial flutter who received IV procainamide at one university hospital ED during a five-year period . The st and ard clinical protocol involved IV infusion of 1 g of procainamide over 60 minutes , followed by electrical cardioversion if necessary . A trained observer extracted data from the original clinical records . Outcome measurements included conversion to sinus rhythm , adverse events , and relapse up to seven days . RESULTS The 341 study patients had a mean age of 63.9 years ( SD + /- 15.5 years ) , and 56.6 % were male . The conversion rates were 52.2 % ( 95 % confidence interval = 47 % to 58 % ) for 316 atrial fibrillation cases and 28.0 % ( 95 % confidence interval = 13 % to 46 % ) for 25 atrial flutter cases . Mean dose given was 860.7 mg ( SD + /- 231.2 mg ) , and median time to conversion was 55 minutes . Adverse events occurred in 34 cases ( 10.0 % ) : hypotension , 8.5 % ; bradycardia , 0.6 % ; atrioventricular block , 0.6 % ; and ventricular tachycardia , 0.3 % . There were no cases of torsades de pointes , cerebrovascular accident , or death . Most patients ( 94.4 % ) were discharged home , but 2.9 % of patients returned with a recurrence of atrial fibrillation within seven days . CONCLUSIONS This study of acute atrial fibrillation or flutter patients treated in the ED with IV procainamide suggests that this treatment is safe and effective in this setting . Procainamide should be prospect ively compared with other ED strategies
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 .