Is Discharge to Home After Emergency Department Cardioversion Safe for the Treatment of Recent-Onset Atrial Fibrillation?

Besser, Kiera von; Mills, Angela M.

doi:10.1016/j.annemergmed.2011.06.014

Cited by 36 publications

(11 citation statements)

References 14 publications

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“…For patients with AF or atrial flutter of less than 48-hour duration who are at low thromboembolic risk, anticoagulation (intravenous heparin, LMWH, or a new oral anticoagulant) or no antithrombotic therapy may be considered for cardioversion, without the need for postcardioversion oral anticoagulation (326). (Level of Evidence: C) …”

Section: Rhythm Controlmentioning

confidence: 99%

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

January¹,

Wann²,

Alpert³

et al. 2014

Circulation

3,575

1,139

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Section: Rhythm Controlmentioning

confidence: 99%

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

January¹,

Wann²,

Alpert³

et al. 2014

Circulation

3,575

1,139

View full text Add to dashboard Cite

“…This includes early assessment and cardioversion, followed by a brief observation period, and subsequent discharge of stable patients from the ED. Published data support these new paradigms as safe and logistically feasible alternatives to inpatient management of appropriately selected patients with AF 11, 12, 13, 14, 15. The implementation of these strategies has been shown to result in substantial reductions in hospital admission rates and costs 13, 14, 15.…”

Section: Discussionmentioning

confidence: 98%

“…The annual cost of AF treatment was estimated to be $6.65 billion in 2005,7 and later estimates were even higher 10. Intervention programs at the emergency department (ED) level have been investigated and successfully implemented in some academic centers in recent years to reduce the hospitalization rates for AF and their associated costs 11, 12, 13, 14, 15…”

Section: Introductionmentioning

confidence: 99%

Emergency Department Visits for Atrial Fibrillation in the United States: Trends in Admission Rates and Economic Burden From 2007 to 2014

Rozen

Hosseini

Kaadan

et al. 2018

JAHA

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BackgroundAtrial fibrillation (AF) is an increasingly prevalent public health problem and one of the most common causes of emergency department (ED) visits. We aimed to investigate the trends in ED visits and hospital admissions for AF.Methods and ResultsThis is a repeated cross‐sectional analysis of ED visit‐level data from the Nationwide Emergency Department Sample for 2007 to 2014. We identified adults who visited EDs in the United States, with a principal diagnosis of AF. A sample of 864 759 ED visits for AF, representing a weighted total of 3 886 520 ED visits, were analyzed. The annual ED visits for AF increased by 30.7% from 411 406 in 2007 (95% confidence interval, 389 819–432 993) to 537 801 (95% confidence interval, 506 747–568 855) in 2014. Patient demographics remained consistent, with an average age of 69 to 70 years and slight female predominance (51%–53%) throughout the study period. Hospital admission rates were stable at ≈70% between 2007 and 2010, after which they gradually declined to 62% in 2014 (P trend=0.017). Despite the decline in hospital admission rates, AF hospitalizations increased from 288 225 in 2007 to 333 570 in 2014 because of the increase in total annual ED visits during the study. The adjusted annual charges for admitted AF patients increased by 37% from $7.39 billion in 2007 to $10.1 billion in 2014.ConclusionsAnnual ED visits and hospital admissions for AF increased significantly between 2007 and 2014, despite a reduction in admission rates. These data emphasize the need for widespread implementation of effective strategies aimed at improving the management of patients with AF to reduce hospital admissions and the economic burden of AF.

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“…This is despite several U.S. studies supporting cardioversion in the ED. [15][16][17][18] Von Besser and Mills 19 recently reviewed published ED studies and concluded that aggressive management in U.S. EDs should be acceptable. Other Canadian and Australian studies have also evaluated aggressive management of RAF in the ED.…”

Section: Discussionmentioning

confidence: 99%

An International View of How Recent‐onset Atrial Fibrillation Is Treated in the Emergency Department

Rogenstein

Kelly

Mason

et al. 2012

Academic Emergency Medicine

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Is Discharge to Home After Emergency Department Cardioversion Safe for the Treatment of Recent-Onset Atrial Fibrillation?

Cited by 36 publications

References 14 publications

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

Emergency Department Visits for Atrial Fibrillation in the United States: Trends in Admission Rates and Economic Burden From 2007 to 2014

An International View of How Recent‐onset Atrial Fibrillation Is Treated in the Emergency Department

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