Patients experiencing acute atrial fibrillation with no known medical cause were found to have a less than 1 percent risk of experiencing a stroke or death within 30 days of an emergency room visit.
"Follow up with a cardiologist after an arrhythmia-related emergency room visit."
Frank Xavier Scheuermeyer, MD, MHSc, a lead author from St. Paul's Hospital in Canada, initiated the study because little research has examined longer-term outcomes of atrial fibrillation patients with no apparent underlying medical cause following a hospital emergency room visit.
During the cohort study researchers followed 927 consecutive patients with acute atrial fibrillation who visited a hospital emergency room between April 2006 and March 2010. Patients with underlying medical conditions that could have caused the heart arrhythmia were excluded from the study.
The patients were divided into five groups based on their treatment including electrocardioversion, chemical cardioversion, spontaneous cardioversion, rate control only and no arrhythmia-specific treatment.
Investigators identified repeat emergency room visits, strokes and deaths within 1 year by following patients' assigned unique provincial health numbers, which is linked to the vital statistics registry and the emergency department database.
Of the patients followed, 13 percent converted to a normal heart rhythm before emergency department intervention, while 39 percent required rhythm control treatment. Of the nearly 1,000 participants, 142, or 15 percent, were admitted to the hospital.
At the 30-day mark, two patients had experienced a stroke and five had died, less than 1 percent of patients. The risk of complications also remained very low 1 year after the initial atrial fibrillation incident.
The study was recently published in the Annals of Emergency Medicine.