Premium
Optimal Management of the Patient with an Episode of Atrial Fibrillation In and Out of the Hospital
Author(s) -
KNIGHT BRADLEY P.,
MORADY FRED
Publication year - 1999
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1999.tb00696.x
Subject(s) - knight , medicine , electrical cardioversion , atrial fibrillation , management of atrial fibrillation , center (category theory) , university hospital , general hospital , medical emergency , emergency medicine , cardioversion , chemistry , physics , astronomy , crystallography
The optimal management of a patient with new-onset atrial fibrillation (AF) is highly individualized. Frequently, the key management decision is whether or not to perform acute cardioversion. This decision involves asking two questions: (1) should cardioversion be performed at all? And, if so, (2) should cardioversion be performed acutely or should it be delayed? To answer the first question, the benefits of sinus rhythm, the risks of cardioversion, and the likelihood of recurrence must be considered. The answer to the second question depends largely on the duration of AF. In patients who have had AF for 48 hours, or in whom the duration is unclear, an atrial thrombus must be excluded by a transesophageal echocardiogram (TEE) if acute cardioversion is being considered, unless the situa-