Why the study?
The exact frequency and clinical determinants of spontaneous conversion in patients with symptomatic recent-onset AF are unclear.
What is the frequency and what are the determinants of spontaneous conversion to sinus rhythm in patients presenting to the emergency department with recent-onset atrial fibrillation?
What is the frequency and what are the determinants of spontaneous conversion to sinus rhythm in patients presenting to the emergency department with recent-onset atrial fibrillation?
Spontaneous conversion of recent-onset AF in the ED is highly variable (9-83%) and is most likely in patients with short AF duration, fewer prior episodes, normal atrial size, and no prior heart disease.
Supports selective ED observation in low-risk recent-onset AF; reinforces predictors for risk stratification and trial eligibility.
The exact frequency and clinical determinants of spontaneous conversion (SCV) in patients with symptomatic recent-onset AF are unclear. The aim of this systematic review is to provide an overview of the frequency and determinants of SCV of AF in patients presenting at the emergency department. A comprehensive literature search for studies about SCV in patients presenting to the emergency department with AF resulted in 25 articles - 12 randomised controlled trials and 13 observational studies. SCV rates range between 9-83% and determinants of SCV also varied between studies. The most important determinants of SCV included short duration of AF (<24 or <48 hours), low number of episodes, normal atrial dimensions and absence of previous heart disease. The large variation in SCV rate and determinants of SCV was related to differences in duration of the observation period, inclusion and exclusion criteria and in variables used in the prediction models.
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Pluymaekers et al. (2020) studied this question.
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