An International View of How Recent-onset Atrial Fibrillation Is Treated in the Emergency Department

Objectives This study was conducted to determine if there is practice variation for emergency physicians’ (EPs) management of recent‐onset atrial fibrillation (RAF) in various world regions (Canada, United States, United Kingdom, and Australasia). Methods The authors completed a mail and e‐mail surv...

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Bibliographic Details
Published in:Academic emergency medicine 2012-11, Vol.19 (11), p.1255-1260
Main Authors: Rogenstein, Carly, Kelly, Anne-Maree, Mason, Suzanne, Schneider, Sandra, Lang, Eddy, Clement, Catherine M., Stiell, Ian G.
Format: Article
Language:English
Subjects:
Adult
Anti-Arrhythmia Agents - therapeutic use
Anticoagulants - therapeutic use
Atrial Fibrillation - diagnosis
Atrial Fibrillation - therapy
Australasia
Canada
Cardiac arrhythmia
Chi-Square Distribution
Conscious Sedation - methods
Disease management
Electric Countershock - utilization
Emergency medical care
Emergency Medicine - standards
Emergency Medicine - trends
Emergency Service, Hospital
Female
Health Care Surveys
Heart Rate
Humans
International comparisons
International Cooperation
Male
Medical treatment
Middle Aged
Physicians
Practice Patterns, Physicians' - trends
Surveys and Questionnaires
Survival Rate
Treatment Outcome
United Kingdom
United States
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Summary:Objectives This study was conducted to determine if there is practice variation for emergency physicians’ (EPs) management of recent‐onset atrial fibrillation (RAF) in various world regions (Canada, United States, United Kingdom, and Australasia). Methods The authors completed a mail and e‐mail survey of members from four national emergency medicine (EM) associations. One prenotification letter and three survey letters were sent to members of the Canadian Association of Emergency Physicians (CAEP; Canada—1,177 members surveyed), American College of Emergency Physicians (ACEP; United States—500), College of Emergency Medicine UK (CEM; United Kingdom—1,864), and Australasian College for Emergency Medicine (ACEM; Australasia—1,188) as per the modified Dillman technique. The survey contained 23 questions related to the management of adult patients with symptomatic RAF (either a first episode or paroxysmal‐recurrent) where onset is less than 48 hours and cardioversion is considered a treatment option. Data were analyzed using descriptive and chi‐square statistics. Results Response rates were as follows: overall, 40.5%; Canada, 43.0%; United States, 50.1%; United Kingdom, 38.1%; and Australasia, 38.0%. Physician demographics were as follows: 72% male and mean (±SD) age 41.7 (±8.39) years. The proportions of physicians attempting rate control as their initial strategy are United States, 94.0%; Canada, 70.7%; Australasia, 61.1%; and United Kingdom, 43.1% (p 
ISSN:1069-6563
1553-2712
DOI:10.1111/acem.12016