Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomised trial

Stiell, Ian G.; Sivilotti, Marco L.A.; Taljaard, Monica; Birnie, David H.; Vadeboncœur, Alain; Hohl, Corinne M.; McRae, Andrew; Rowe, Brian H.; Brison, Robert J.; Thiruganasambandamoorthy, Venkatesh; Macle, Laurent; Borgundvaag, Bjug; Morris, Judy; Mercier, Éric; Clement, Catherine M.; Brinkhurst, Jennifer; Sheehan, Connor M.; Brown, Erica; Nemnom, Marie‐Joe; Wells, George A.; Perry, Jeffrey J.

doi:10.1016/s0140-6736(19)32994-0

Cited by 77 publications

(82 citation statements)

References 37 publications

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“…Although it has been verified that rate control and rhythm control contribute to similar outcomes, rhythm control is often received to reduce AF symptoms [80]. A recent study reported that immediate rhythm control for patients in the emergency department with acute AF lead to excellent outcomes [81]. Catheter ablation and antiarrhythmic drugs are the most commonly used methods of converting to normal sinus rhythm.…”

Section: Future Prospects Of Sk Channel Inhibitors In Therapeutics Of Afmentioning

confidence: 99%

Modulation of SK Channels: Insight Into Therapeutics of Atrial Fibrillation

Qian

Wang

2021

Heart, Lung and Circulation

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Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the world. Although much technological progress in the treatment of AF has been made, there is an urgent need for better treatment of AF due to its high rates of morbidity and mortality. The anti-arrhythmic drugs currently approved for marketing have significant limitations and side effects such as life-threatening ventricular arrhythmias and hypotension. The small conductance Ca 21-activated K 1 channels (SK channels) are dependent on intracellular Ca 21 concentrations, which tightly integrate with membrane potential. Given the predominant expression in the atria of many species, including humans, they are now emerging as a therapeutic target for treating AF. This review aimed to illustrate the characteristics and function of SK channels. Moreover, it discussed the regulation of SK channels and their potential as a therapeutic target of AF.

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Section: Future Prospects Of Sk Channel Inhibitors In Therapeutics Of Afmentioning

confidence: 99%

Modulation of SK Channels: Insight Into Therapeutics of Atrial Fibrillation

Qian

Wang

2021

Heart, Lung and Circulation

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“…27,28 Rana kontrola ritma u AF-u u hitnoj službi istražena je u drugom randomiziranom istraživanju uspoređujući primjenu prokainamida i spašavajuće električne kardioverzije po potrebi s trenutačnom električnom kardioverzijom. 29 Obje su strategije bile klinički vrlo učinkovite, ali su autori pokazali da se preferira trenutačna kardioverzija jer je to manje opterećujuće za bolesnike i bolnicu.…”

Section: Randomized Trials On Integrated Care In Atrial Fibrillationunclassified

The year in cardiovascular medicine 2020: arrhythmias

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et al. 2021

European Heart Journal

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Summary of the progress in arrhythmias in 2020. RACE4 and ALL-IN indicated that integrated nurse-led care improves outcomes in AF patients.3,4 The same was reported for early rhythm control therapy15 and cryoablation as initial AF treatment.25,26 Subcutaneous ICD was non-inferior to classical transvenous ICD therapy in PRAETORIAN.54 One mechanistic study showed that autoantibodies against misexpressed actin, keratin, and connexin-43 proteins create a blood-borne biomarker profile enhancing diagnosis of Brugada syndrome.50 Another mechanistic study indicated that transseptal LV pacing yields similar improvement in contractility as His bundle pacing whilst being more easy to execute.44 In PRE-DETERMINE a simple-to-use ECG risk score improved risk prediction in patients with ischemic heart disease possibly enhancing appropriate ICD therapy in high risk patients.58

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“…Biphasic waveform shock had higher success rates with lower provided energies than monophasic waveform CV [42]. Anteroposterior pads placement is generally considered to be superior to the anterolateral position, even if a recent trial has not confirmed these findings [20,43].…”

Section: Electrical Cardioversionmentioning

confidence: 99%

“…There are few evidence-based comparisons between "pure" pharmacological versus "pure" electrical CV in recent-onset AF and it is still a matter of debate which is the best approach in terms of feasibility, cost, risks and effectiveness. In the recent RAFF2 trial (Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation), both drug-shock and shock-only strategies were highly effective and safe as CV strategies indeed [20].…”

Section: Electrical Cardioversionmentioning

confidence: 99%

“…Moreover, early CV in the emergency department has been shown to be safe and effective and significantly reduces healthcare costs. Both electrical and pharmacological CV can be effective in restoring SR [20]. Nevertheless, current guidelines do not uniformly agree on which drug to use for pharmacological CV, and drug preference varies widely in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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