• Camilla Fundarò, Andrea Galli, Stefano Paglia, Silvia Colombo, Angelo Rovellini, Livio Colombo, Valter Monzani, Daniele Coen, and Stefano Guzzetti.
• Department of Emergency Medicine ‘Luigi Sacco’ Hospital, Milano, Italy.
• Emerg Med J. 2012 Apr 1;29(4):284-6.

BackgroundCurrent guidelines do not provide definitive indications about the treatment in emergency departments (ED) of patients with recent-onset atrial fibrillation (AF).MethodsA 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.ResultsOn 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).ConclusionAccording to the study results, rhythm at the time of ED discharge is a poor indicator of the short-term evolution of AF.

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