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Atrial Fibrillation- Acute Onset

June 6, 2008

BMJ clinical evidence looks at this review of treatment of Acute onset of AF. THey used these three clinical questions in pateints with hemodynamically stable acute AF.

  • What are the effects of intervention to prevent embolism in recent onset AF?
  • What are the effects of interventions for conversion to sinus rhythm in recent onset AF?
  • What are the effects of interventions to control rate in recent onset AF?

Answers are here.

What are the effects of interventions to prevent embolism in people with recent-onset atrial fibrillation who are haemodynamically stable?
Unknown effectiveness

* Antithrombotic treatment before cardioversion


What are the effects of interventions to control heart rate in people with recent-onset atrial fibrillation who are haemodynamically stable?

Likely to be beneficial

* Amiodarone for rate control
* Digoxin for rate control
* Diltiazem for rate control
* Timolol for rate control
* Verapamil for rate control


Unknown effectiveness

* Sotalol for rate control


What are the effects of interventions for conversion to sinus rhythm in people with recent-onset atrial fibrillation who are haemodynamically stable?

Trade off between benefits and harms

* Amiodarone for rhythm control
* Flecainide for rhythm control
* Propafenone for rhythm control


Unknown effectiveness

* Direct current cardioversion for rhythm control *
* Quinidine for rhythm control
* Sotalol for rhythm control
* Verapamil for rhythm control

Unlikely to be beneficial

* Digoxin for rhythm control



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