University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Emergency Medicine


Watkins, Elyse, DHSc, PA-C; Akopian, Erik MD; Yvanovich, Anthony DMSc, PA-C


Atrial fibrillation is one of the most common sustained arrhythmias accounting for a significant amount of emergency department visits requiring hospital admissions. Emergency medicine providers must be knowledgeable of evidence-based rate and rhythm control strategies for patient stabilization and prevention of complications. This article assesses the prevailing research as it pertains to options, indications, contraindications, and safe implementation of rate and rhythm control strategies for emergency department providers. Rate control strategies remain the primary mode of stabilization in most patients, with rhythm control having indications in hemodynamically unstable patients as well as specific clinical circumstances. Recent studies have suggested early rhythm control may have potential benefits in newly diagnosed patients, reducing risk of strokes, cardiovascular deaths, and disease progression. Rate and rhythm control strategies must be individualized keeping in mind the patient’s duration of symptoms, comorbidities, clinical circumstances, and quality of life.


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