Key result
Initial ED arrhythmia diagnoses achieve only ~58% accuracy in a cross-sectional study.
Why the study?
Cardiac arrhythmias present diagnostic and therapeutic challenges in emergency departments, with unclear accuracy and management practices in this setting.
Cross-Sectional (n=40)
No
A high proportion of cardiac arrhythmias in the emergency department are diagnosed and managed inappropriately, highlighting a critical need for standardized protocols and enhanced training in ECG interpretation.
Frequent inaccurate arrhythmia diagnosis and management in this Colombian ED signals potential care gaps; leaves open whether targeted training improves outcomes in similar settings.
Introduction. Cardiac arrhythmias represent a diagnostic and therapeutic challenge in emergency departments. Objective. To describe the diagnostic accuracy and management practices of cardiac arrhythmias in the emergency department of a tertiary hospital in Pereira, Colombia. Method. An observational, cross-sectional study was conducted. Data were collected from the medical records of patients diagnosed and managed for arrhythmias between November 2023 and May 2024. Sociodemographic, clinical, and therapeutic variables were included; diagnoses and management were classified as appropriate or inappropriate by trained physicians based on clinical practice guidelines and admission electrocardiograms (ECGs). Bioethical approval was obtained. Results. A total of 40 patients met the inclusion criteria. The mean age was 71.5 (SD: 14.1) years, and the majority were men (n = 26; 65.0%). The most frequent initial diagnosis was atrial fibrillation (n = 21; 52.5%). The most frequent treatment was drug therapy, mainly with metoprolol (n = 11; 27.5%) and amiodarone (n = 5; 12.5%). Electrical cardioversion was used in five patients (12.5%). In seven patients, the admission ECG could not be verified. Ultimately, 57.6% of the initial diagnoses were found to be accurate (n = 19 of 33 patients with ECG). Of the management options, 54.5% were appropriate. Conclusion. Although most patients received appropriate treatment, a high proportion were diagnosed and managed in a potentially inappropriate manner. Atrial fibrillation was the most common arrhythmia.
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Ceballos-Rivera et al. (2025) conducted a cross-sectional in Cardiac arrhythmias (n=40). Emergency department diagnosis and management of cardiac arrhythmias was evaluated on Diagnostic accuracy of initial arrhythmia diagnosis. Among patients presenting with cardiac arrhythmias to a Colombian emergency department, 57.6% received an accurate initial diagnosis and 54.5% received appropriate management.
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