Department of Emergency Medicine ‘Luigi Sacco’ Hospital, Milano, Italy.
Emerg Med J. 2012 Apr;29(4):284-6. doi: 10.1136/emj.2010.107581. Epub 2011 Mar 25.
Current guidelines do not provide definitive indications about the treatment in emergency departments (ED) of patients with recent-onset atrial fibrillation (AF).
A multicentre observational study involving four general hospitals of the same metropolitan area was conducted. All consecutive adult patients admitted to the ED with recent symptoms of AF (<48 h duration) and discharged home were considered. Patients who underwent ED early cardioversion were enrolled in group A. Patients managed with ventricular rate control were enrolled in group B.
On the 24 h Holter recordings at 1-week follow-up, stable sinus rhythm was detected in 46/58 (79.3%; 95% CI 68.9 to 89.7) patients in group A and 8/33 (24.2%; 95% CI 9.6 to 38.9) patients in group B (p<0.01).
According to the study results, rhythm at the time of ED discharge is a poor indicator of the short-term evolution of AF.
目前的指南并没有明确指出在急诊科（ED）对新发心房颤动（AF）患者的治疗方法。
进行了一项涉及同一大都市区的四家综合医院的多中心观察性研究。所有因新发 AF 症状（<48 小时）而被收入 ED 并出院回家的成年患者均被视为研究对象。在 ED 进行早期心脏复律的患者被纳入 A 组。心室率控制管理的患者被纳入 B 组。
在第 1 周的 24 小时动态心电图记录中，A 组的 46/58（79.3%；95%CI 68.9 至 89.7）名患者和 B 组的 8/33（24.2%；95%CI 9.6 至 38.9）名患者检测到稳定的窦性心律（p<0.01）。
根据研究结果，ED 出院时的节律是 AF 短期演变的不良指标。
