Recent onset atrial fibrillation – rhythm control versus rate control

Introduction: Atrial fibrillation is one of the leading global causes of stroke, sudden death, as well as car-diovascular morbidity, despite recent progress in its management. Studies such as AFFIRM, RACE, AF-CHF did not prove the superiority of rhythm control versus heart rate control. Currently, an optimal control of heart rate is preferred in elderly, asymptomatic pati-ents, even when rhythm control is not possible.

Objective: The current study aims to analyze the ma-nagement of patients admitted in the emergency room for recent onset atrial fibrillation of unknown debut.

Methods: The current retrospective study is aimed at a number of 62 patients admitted into the Cardiology Department of the Timisoara Municipal Clinical Emer-gency Hospital during a period of one year (2015), for recent onset atrial fibrillation. Studied parameters in-cluded age, gender, residence, symptoms upon admis-sion, comorbidties, administered treatment, left atrium dimensions, heart rate upon admission/discharge, and conversion to sinus rhythm. Data was processed using Microsoft Excell.

Results: Of 506 patients addressed to the emergen-cy room for atrial fibrillation, 49% were admitted, 62 (25%) of which were diagnosed with recent onset atri-al fibrillation. The study showed that this pathology is more frequent in men (52%), in the urban setting (66%), in patients with an age greater than 60 years (84%). The most frequent symptoms were palpitation, fatigue, thoracic discomfort, dyspnoea upon exertion. Most patients were hypertensive (71%). 60% had a left atrium of normal dimensions, sinus rhythm conversi-on being more frequent in these patients (34% in those with a normal left atrium versus 20% with an enlarged left atrium). Sinus rhythm conversion was assessed in regard to antiarrhythmic treatment, as well as heart rate upon discharge in all patients.

Conclusions: A early antiarrhythmic treatment is pa-ramount in patients with recent onset atrial fibrillati-on of unknown debut, not only to obtain sinus rhythm conversion, but to also obtain heart rate control in or-der to decrease morbidity and mortality.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)