Rapid Atrial Fibrillation in the Emergency Department

Mochamad Yusuf Alsagaff, Hendri Susilo, Christian Pramudia, Dafsah Arifa Juzar, Muhammad Rafdi Amadis, Rerdin Julario, Sunu Budhi Raharjo, Budi Baktijasa Dharmadjati, Terrence Timothy Evan Lusida, Yusuf Azmi, Pieter A.F.M. Doevendans

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)


Atrial fibrillation (AF) is the most common rhythm disorder seen in doctors’ offices and emergency departments (EDs). In both settings, an AF holistic pathway including anticoagulation or stroke avoidance, better symptom management, and cardiovascular and comorbidity optimization should be followed. However, other considerations need to be assessed in the ED, such as haemodynamic instability, the onset of AF, the presence of acute heart failure and pre-excitation. Although the Advanced Cardiovascular Life Support guidelines (European Society of Cardiology guidelines, Acute Cardiac Care Association/European Heart Rhythm Association position statements) and several recent AF publications have greatly assisted physicians in treating AF with rapid ventricular response in the ED, further practical clinical guidance is required to improve physicians’ skill and knowledge in providing the best treatment for patients. Herein, we combine multiple strategies with supporting evidence-based treatment and experiences encountered in clinical practice into practical stepwise approaches. We hope that the stepwise algorithm may assist residents and physicians in managing AF in the ED.

Original languageEnglish
Pages (from-to)12-19
Number of pages8
JournalHeart International
Issue number1
Publication statusPublished - 2022


  • Atrial fibrillation
  • cardioversion
  • emergency department
  • rate control
  • rhythm control
  • Wolff–Parkinson–White syndrome


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