Summary
Emergency department observation unit: an adequate place for the management of atrial flutter
Aldea-Molina E, Gómez Jiménez J, Royo R, Rodrigo G, Rivas M, Llera R
Affiliation of the authors
Emergency department and Arrhythmia Unit of Hospital Clínico Universitario “Lozano Blesa” in Saragossa, Spain.
DOI
Quote
Aldea-Molina E, Gómez Jiménez J, Royo R, Rodrigo G, Rivas M, Llera R. Emergency department observation unit: an adequate place for the management of atrial flutter. Emergencias. 2008;20:101-7
Summary
Background: The Emergency Observation Unit (EOU) plays a central role in the attention
and monitorization of patients with urgent conditions. Nevertheless, data regarding
the management of atrial flutter at emergency departments are scarce.
Aim: The aim of the present study was to assess the effectiveness of flutter management
in patients admitted to the EOU.
Methods: A prospective, descriptive, observational study of all the patients who were
initially diagnosed of atrial flutter at emergency department and later transferred to the
EOU during 36 consecutive months was carried out.
Results: Among 157 patients (mean age 70 years) included in the study, 110 (71%)
were discharged from the EOU, 79% of them within less than 24 hours. The normal
heart rhythm was restored with flecainide in 6 cases (4%, effectiveness 67%), propafenone
in 4 cases (3%, effectiveness 25%) and amiodarone in 77 cases (49%, effectiveness
53%). Electrical cardioversion was used in 11 cases (7%) with effectiveness of
100% and absence of adverse effects. In 61 cases (38,85%) the electrocardiogram showed
sinus rhythm when the patients left the EOU.
Conclusions: The number of patients with atrial flutter discharged from the EOU was
high. Pharmacological effectiveness to restore the heart rhythm was low being amiodarone
and flecainide the most effective drugs. The number of electrical cardioversion
procedures performed for the treatment of atrial flutter in the EOU was low.