Acute Cardioversion Versus Wait And See-approach for Symptomatic Atrial Fibrillation in the Emergency Department

• Status: Completed
• Trial end date: 2019-12-01
• Target enrollment: 0
• Participant gender: All

Summary

A symptomatic episode of the heart rhythm disorder 'atrial fibrillation' (AF) is a frequent reason for visits to the emergency department. Currently, in the majority of cases, immediate (electrical or pharmacological) cardioversion is chosen, while atrial fibrillation terminates spontaneously in 70% of the cases within 24 hours. A wait-and-see approach with rate-control medication only, and when needed cardioversion within 48 hours of onset of symptoms, could be effective, safe and more cost-effective than current standard of care and could lead to a higher quality of life.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Maastricht University Medical Center
• Collaborator: ZonMw: The Netherlands Organisation for Health Research and Development
• Treatments: Amiodarone; Digoxin; Flecainide; Metoprolol; Verapamil

Criteria

Inclusion Criteria:

• ECG with atrial fibrillation at the emergency department

• Heart rate > 70bpm

• Symptoms most probable due to atrial fibrillation

• Duration of symptoms < 36 hours

• > 18 years of age

• Able and willing to sign informed consent

• Able and willing to use MyDiagnostick

Exclusion Criteria:

• Signs of myocardial infarction on ECG

• Hemodynamic instability (systolic blood pressure < 100mm Hg, heart rate > 170 bpm)

• Presence of pre-excitation syndrome

• History of Sick Sinus Syndrome

• History of unexplained syncope

• History of persistent AF (episode of AF lasting more than 48 hours)

• Acute heart failure

• Currently enrolled in another clinical trial

• Deemed unsuitable for participation by attending physician