Emerg Med J doi:10.1136/emj.2010.107581
  • Short report

Atrial fibrillation in emergency department: prevalence of sinus rhythm 1 week after discharge

  1. Stefano Guzzetti1
  1. 1Department of Emergency Medicine ‘Luigi Sacco’ Hospital, Milano, Italy
  2. 2Department of Emergency Medicine Ospedale Maggiore Niguarda, Milano, Italy
  3. 3Department of Emergency Medicine Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milano, Italy
  4. 4Department of Emergency Medicine Ospedale San Paolo, Milano, Italy
  1. Correspondence to Dr Stefano Guzzetti, Medicina di Urgenza, Via GB Grassi 74, Milano 20157, Italy; guzzetti.stefano{at}
  • Accepted 3 March 2011
  • Published Online First 25 March 2011


Background Current guidelines do not provide definitive indications about the treatment in emergency departments (ED) of patients with recent-onset atrial fibrillation (AF).

Methods A 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.

Results On 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).

Conclusion According to the study results, rhythm at the time of ED discharge is a poor indicator of the short-term evolution of AF.


  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the Ethics Committees of the hospitals involved.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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