What is it about?

This publication describes a study that is currently performed in 13 hospitals in the Netherlands. This study investigates the best treatment for people that come to the emergency department of a hospital with an acute attack of the heart rhythm disorder atrial fibrillation. The currently used strategy involves drugs or an electrical shock to restore the normal heart rhythm, while we know that such an attack terminates spontaneously within 24 hours in over 70% of the cases and that symptoms can effectively taken away with milder drugs. Therefore, this study aims to compare the drugs or electrical shock (current standard of care) with a new strategy that allows the body to restore the normal heart rhythm within 48 hours and only the treatment with an electrical shock if this does not happen.

Featured Image

Why is it important?

The results of this study will help doctors decide which treatment they should propose to a patient that presents with an acute attack of atrial fibrillation in the emergency department. It will show whether both treatment strategies are equally safe and effective, and whether there is a difference in quality of life between the two groups.

Perspectives

This study is important as it fills a gap in our current knowledge. Intuitively it does not feel right to propose invasive treatment, such as an electrical shock, to a patient with a condition that I know will most probably terminate spontaneously within a few hours. I hope that this study will help us decide which treatment is best for which patient, and thereby imporve the medical care for this group of patients.

Dr. Elton AMP Dudink
Maastricht University Medical Center

Read the Original

This page is a summary of: Acute cardioversion vs a wait-and-see approach for recent-onset symptomatic atrial fibrillation in the emergency department: Rationale and design of the randomized ACWAS trial, American Heart Journal, January 2017, Elsevier,
DOI: 10.1016/j.ahj.2016.09.009.
You can read the full text:

Read

Contributors

The following have contributed to this page