After one month, all patients undergo an electrocardiography (ECG) to ensure the maintenance of normal rhythm in both treatment groups. Patients randomized to elective treatment have the possibility to opt-out and undergo acute cardioversion if their symptoms are unmanageable during the first week before the out-patient clinical.Īll patients are monitored for their symptoms by a standardized quality-of-life questionnaire and for possibly required acute medical interventions during the first week and one month after the out-patient clinic. All patients who have not received adequate anticoagulation for three weeks prior to the delayed cardioversion will undergo a transesophageal cardiac ultrasound to ensure they are not in excess risk for thromboembolic events. Due to possibility of delayed cardioversion in the interventional group (elective care group), all patients receive anticoagulation before the out-patient clinic despite their thromboembolic risk. Cardiovascular status and treatment options are evaluated for all patients.Īnticoagulation is managed according existing guidelines for all patients. Patients randomized to elective treatment and still in atrial fibrillation or in atrial flutter will be restored to sinus rhythm by electrical or medical cardioversion at the out-patient clinic. Patients randomized to elective care are discharged immediately after adequate temporary rhythm control is assured.Īll patients will visit a cardiologist out-patient clinic at approximately one week after the emergency room visit. Patients randomized to conventional care are treated conventionally which means acute rhythm control is applied by electrical or medical cardioversion in the emergency department (within 48 hours of onset of the arrhythmia). Patients must be in good clinical condition so that they can be discharged regardless to which treatment modality is randomly selected to them. The main purpose is to observe if these arrhythmias can be safely treated electively (within 5-9 days).Īll patients are recruited in the emergency department. The AFFELECT -study compares two types of treatment modalities for acute atrial fibrillation or flutter for patients in whom rhythm control is desirable. Why Should I Register and Submit Results?.
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