Early or delayed cardioversion in recent-onset atrial fibrillation
- Pluymaekers, N. A. H. A.
- Dudink, E. A. M. P.
- Luermans, J. G. L. M.
- Meeder, J. G.
- Lenderink, T.
- Widdershoven, J.
- Bucx, J. J. J.
- Rienstra, M.
- Kamp, O.
- van Opstal, J. M.
- Alings, M.
- Oomen, A.
- Kirchhof, C. J.
- van Dijk, V. F.
- Ramanna, H.
- Liem, A.
- Dekker, L. R.
- Essers, B. A. B.
- Tijssen, J. G. P.
- van Gelder, I. C.
- Crijns, H. J. G. M.
DOIAbstract
BACKGROUND Patients with recent-onset atrial fibrillation commonly undergo immediate restoration of sinus rhythm by pharmacologic or electrical cardioversion. However, whether immediate restoration of sinus rhythm is necessary is not known, since atrial fibrillation often terminates spontaneously. METHODS In a multicenter, randomized, open-label, noninferiority trial, we randomly assigned patients with hemodynamically stable, recent-onset (<36 hours), symptomatic atrial fibrillation in the emergency department to be treated with a wait-and-see approach (delayed-cardioversion group) or early cardioversion. The wait-and-see approach involved initial treatment with rate-control medication only and delayed cardioversion if the atrial fibrillati...
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