Cardioversion of acute atrial fibrillation in the emergency department: a prospective randomised trial

Bellone, Andrea; Etteri, Massimiliano; Vettorello, Marco; Bonetti, Chiara; Clerici, D; Gini, Giancarlo; Maino, Carlo; Mariani, Massimo A.; Natalizi, Anna; Nessi, Italo; Rampoldi, Alessandro; Colombo, L

doi:10.1136/emj.2010.109702

Cited by 39 publications

(30 citation statements)

References 25 publications

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“…Effectiveness of ECV in our registry was comparable to that reported in the literature (78-97%) [7][8][9][10]. Although some data suggest that in AF, 200 J energy should be started, especially in non--paroxysmal AF [11], we show that about 160 J energy may also be effective.…”

Section: Discussionsupporting

confidence: 86%

Cardioversion of Atrial Fibrillation (RHYTHM-AF) International Registry in Poland

Kiliszek

Opolski

Włodarczyk³

et al. 2014

Cardiol J.

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Section: Discussionsupporting

confidence: 86%

Cardioversion of Atrial Fibrillation (RHYTHM-AF) International Registry in Poland

Kiliszek

Opolski

Włodarczyk³

et al. 2014

Cardiol J.

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“…During 2 months of follow-up recurrence of AF was observed in about 25% of patients -the rate comparable to previous results [14], and the frequency of rehospitalization was about 19% in the whole group (27.7% in the paroxysmal AF) -in one of the earlier studies 33-35% of patients had recurrent visits on Emergency Department during a 6-months of follow-up [15]. In the Euro Heart Survey on Atrial Fibrillation registry, the rate of rehospitalization within 1 year was between 41% (first detected AF episode) and 54% (paroxysmal AF) [9].…”

Section: Discussionsupporting

confidence: 89%

Cardioversion differences among first detected episode, paroxysmal, and persistent atrial fibrillation patients in the RHYTHM AF registry in Poland

Kiliszek¹,

Opolski

Włodarczyk³

et al. 2015

Cardiol J

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“…No serious adverse events were recorded. In 2012 Bellone et al 19 reported a clinical trial involving 121 patients who underwent DCCV in the ED facilitated by procedural sedation with propofol provided by emergency physicians. The primary outcome for this trial was the success rate of cardioversion for acute AF using DCCV versus propafenone.…”

Section: Discussionmentioning

confidence: 99%

Procedural sedation with propofol for emergency DC cardioversion

Kaye

Govier

2013

Emerg Med J

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Many emergency patients present with cardiac arrhythmias requiring emergency direct current countershock cardioversion (DCCV) as a part of their management. Almost all require sedation to facilitate the procedure. Propofol has been used for procedural sedation in Emergency Medicine since 1995. In 1996, in a review article in Anaesthesia, it was recommended as the drug which most closely approaches the ideal agent for DCCV. However, the existing evidence for the dosage requirements and safety of propofol in emergency DCCV is limited. We report a prospective case series of patients who underwent sedation-facilitated DCCV using propofol in the emergency department with both sedation and DCCV delivered by emergency physicians. The results indicate propofol is a safe drug for procedural sedation to facilitate emergency DCCV in patients with an atrial tachyarrhythmia without any evidence of haemodynamic compromise. A dose of 1 mg/kg appears to be safe in the majority of these patients. Using the adverse event reporting tool produced by the World SIVA International Sedation Task Force there were no moderate or sentinel adverse events in these patients. A reduced dose should be considered in older patients to prevent transient complications. Propofol at a dose of 0.5 mg/kg appears to be a safe drug for procedural sedation to facilitate emergent or urgent DCCV in patients with an atrial tachyarrhythmia with evidence of haemodynamic compromise. There were no sentinel adverse events associated with its use. Evidence to support the use of propofol to facilitate emergency DCCV for ventricular tachycardia is limited.

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Cardioversion of acute atrial fibrillation in the emergency department: a prospective randomised trial

Abstract: EC was more effective in patients with acute AF and resulted in a shorter length of stay in the ED than PC. Adverse events were small in number and transient in both groups of patients. Clinical trials registration number NCT00933634.

Cited by 39 publications

References 25 publications

Cardioversion of Atrial Fibrillation (RHYTHM-AF) International Registry in Poland

Cardioversion of Atrial Fibrillation (RHYTHM-AF) International Registry in Poland

Cardioversion differences among first detected episode, paroxysmal, and persistent atrial fibrillation patients in the RHYTHM AF registry in Poland

Procedural sedation with propofol for emergency DC cardioversion

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