In the era of cost containment, we are constantly evaluating clinical conditions which can just as effectively, but more efficiently, be cared for in lower cost observation units. Looks like we can add new onset afib to the list. In this single academic center, 153 patients with new (<48 hours) uncomplicated afib were randomized to management in the ED obs unit, or traditional inpatient unit. Short term rate to sinus rhythm was not significantly different, nor was the rate of recurrence or adverse events. However, median length of stay was 10 versus 25 hours. In ED observation units with cardioversion capabilities, management of new afib will likely be as effective and more efficient, than hospital admission (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.