title: Must antidysrhythmic agents be given to all patients with new-onset atrial fibrillation?
abstract: We investigated the spontaneous conversion rate of new-onset atrial fibrillation (AF) in emergency department patients and the recurrence rate of AF during a 1 month follow-up period. Sixty-six consecutive hemodynamically stable patients presenting to a university hospital emergency department with new-onset atrial fibrillation (less than 72 hours duration) comprised the study population. Patients were initially monitored for 8 hours and observed for spontaneous conversion of AF to sinus rhythm. If conversion did not occur in the first 8 hours, an oral loading dose (600 mg) of propafenone was given, and patients were observed for an additional 8 hours. All patients were reevaluated at 24 hours and at 1 month. The spontaneous conversion rate in patients presenting within 6 hours of AF onset during the initial 8-hour observation period was 71%. The spontaneous conversion rate for all patients during the initial observation period was 53%. The conversion rates between patients presenting "early" (less than 6 hours) and "late" (7-72 hours) were significantly different (P < 0.001). Many patients with new-onset AF, especially those with atrial fibrillation duration less than 6 hours, may need observation only, rather than immediate intervention, to treat their dysrhythmia.
authors.affiliation: Department of Emergency Medicine, Dokuz Eylul University Medical Center, Izmir, Turkey.
authors.forename: U
authors.initials: U
authors.lastname: Ergene
authors.forename: O
authors.initials: O
authors.lastname: Ergene
authors.forename: J
authors.initials: J
authors.lastname: Fowler
authors.forename: O
authors.initials: O
authors.lastname: Kinay
authors.forename: Y
authors.initials: Y
authors.lastname: Cete
authors.forename: C
authors.initials: C
authors.lastname: Oktay
authors.forename: C
authors.initials: C
authors.lastname: Nazli
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016903:Drug Monitoring; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011405:Propafenone / Q000627:therapeutic use*; D012008:Recurrence; D012075:Remission, Spontaneous; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone