The results of emergency medical care for patients with paroxysmal atrial fibrillation

Abstract

The main purpose of the study was to assess the quality and effectiveness of emergency medical care (EMC)in atrial fibrillation paroxysm (AF) at the prehospital stage. Materials and methods: the analysis included 111 patients who called an ambulance due to AF paroxysm. The patients were divided into groups depending on the recovery of sinus rhythm in the presence of a team. A telephone survey of patients was conducted 30 days after seeking medical help. Results: the sinus rhythm in the presence of the brigade was restored in 40% of cases. At the same time, the median recovery time of the rhythm was 32 minutes [Q1–Q3: 29–50]. 9% of patients were hospitalized. 53% of patients refused hospitalization. The probability of rhythm recovery increased with the help of a medical team and was not associated with the choice of an antiarrhythmic and the use of potassium and magnesium drugs. At the same time, in the next 30 days, complications (hospitalization, recurrence of AF and repeated call an ambulance) were observed more often among patients with restored rhythm (43% vs. 12%;p=0.00022). In 60.5% of patients who were trying to restore the rhythm, No anticoagulants were used, and in 7% 2 anticoagulants were used simultaneously. Conclusion. When providing EMC at the prehospital stage, rhythm restoration in the presence of a team is observed in 40% of cases, which is associated with a large number of complications in the next 30 days and a large percentage of errors associated with anticoagulant therapy.