title: Is emergency department cardioversion of recent-onset atrial fibrillation safe and effective?
abstract: BACKGROUND
  Atrial fibrillation (AF) is a very common dysrhythmia presenting to Emergency Departments (EDs). Controversy exists regarding the optimal clinical therapy for these patients, which typically focuses on rhythm rate-control and admission or cardioversion and discharge home.
  
  
  OBJECTIVE
  Is ED cardioversion of recent-onset atrial fibrillation safe, effective, and does it result in positive meaningful patient outcomes?
  
  
  METHODS
  Five observation studies with nearly 1600 ED patients with atrial fibrillation treated with either rate-control or cardioversion were reviewed and results compiled.
  
  
  RESULTS
  Overall, ED cardioversion for recent-onset AF seems safe and effective, with success rates ranging from 85.5% to 97% in these studies. Although further research should seek to identify patients at low risk for thromboembolic complication, more rigorously assess patient satisfaction, and show cost savings, emergency physicians should feel comfortable using this approach in select patients.
  
  
  CONCLUSIONS
  ED cardioversion for recent-onset AF seems safe and effective.
authors: Division of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
authors: Brian G
authors: BG
authors: Cohn
authors: Samuel M
authors: SM
authors: Keim
authors: Donald M
authors: DM
authors: Yealy
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000628:therapy*; D004554:Electric Countershock; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine; D006801:Humans; D010351:Patient Discharge; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents