Conclusion
In this retrospective, single-center study, patients who presented with
atrial fibrillation for more than 48 hours after a TEE negative for an
atrial clot, and who were cardioverted in the ED had a significantly
decreased time to cardioversion and decreased length of hospital stay
when compared to those cardioverted in the cardiological department.
There was no significant difference in complications or 30-day
readmission rates for either group. This clinical pathway may be
implemented in ED observation units. Prospective randomized controlled
trials should be conducted to determine the applicability and
cost-effectiveness of such a clinical pathway in other ED settings.
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