title: Management of atrial fibrillation in the Emergency Department: current approach and future expectations.
abstract: Atrial fibrillation (AF) is the most common cardiac dysrhythmia and occurs in 3.3%-10% of emergency admissions. It is frequently quoted for people over the age of 75, but the cases of AF in young subjects without structural heart disease are also increasing, therefore, leading to the evaluation of "lonely atrial fibrillation" as a new challenge for the clinician. The first diagnosis and treatment often occur in the emergency room and the emergency physician has therefore to evaluate the initial step towards the therapeutic decisions. Although international standard guidelines are available, AF treatment in the Emergency Department (ED) is still heterogeneous in terms of the management strategy chosen. There are two main strategies for the management of AF: rate and rhythm control. Moreover, antithrombotic treatment is pivotal in AF to prevent cardioembolic stroke and it is considered a primary objective after an accurate assessment of antithrombotic treatment risks and benefits. The introduction of innovative echocardiographic approach, directly in ED, seems to improve the management and risk stratification of patients with AF. This review aims to provide an overview about the current approach and the future expectations in the management of AF in ED. This manuscript represents a synopsis of the lectures on AF management in the ED of the Third Italian GREAT Network Congress, that was hold in Rome, 15-19 October 2012. We decided to use only the most relevant references for each contribution as suggested by each participant at this review.
authors: Emergency Medicine Department, Sant'Andrea Hospital, School of Medicine and Psychology, "Sapienza" University Rome, Rome, Italy. veryo85@hotmail.it.
authors: V
authors: V
authors: Russo
authors: S
authors: S
authors: Navarin
authors: G
authors: G
authors: Zampini
authors: L
authors: L
authors: Magrini
authors: C
authors: C
authors: Mann
authors: M L
authors: ML
authors: Muiesan
authors: R
authors: R
authors: De Caterina
authors: M B
authors: MB
authors: Yılmaz
authors: O
authors: O
authors: Beton
authors: V
authors: V
authors: Monzani
authors: J
authors: J
authors: Kubica
authors: C
authors: C
authors: Müller
authors: S
authors: S
authors: Di Somma
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000628:therapy*; D016507:Cardiology Service, Hospital / Q000592:standards / Q000639:trends*; D004636:Emergency Service, Hospital / Q000592:standards / Q000639:trends*; D005544:Forecasting; D006801:Humans; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome