Potential use of amiodarone to treat new-onset AF in the pre-hospital setting
Brown, Philip
Brown, Philip
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Abstract
Abstract published with permission.
Incidence of atrial fibrillation (AF) is high, it is the most prevalent arrhythmia in
the UK, Europe and the USA (Naccarelli et al, 2009; Davis et al, 2012; Dagres
et al, 2013) and is associated with significant morbidity, high risk of stroke and
mortality (Cottrell, 2012). Clinical guidance from the National Collaborating
Centre for Chronic Conditions (NCCCC) (2006) and the National Institute for
Health and Care Excellence (NICE) (2006) supports clinicians working in primary
and hospital-based emergency care, but not those working in pre-hospital care.
Updated guidance from NICE (2014) highlights the importance of providing
rapid, personalised, evidence-based care, yet does not provide any guidance for
pre-hospital clinicians responding to emergency presentations of AF. Paramedics
have knowledge and experience of identifying AF, possess antiarrhythmic,
anticoagulant and anti-platelet medications as part of their formulary and
possess the necessary skills for obtaining intravenous access.
This article reviews the national guidance and available best-evidence to provide
safe treatment to patients presenting with new-onset AF and considers areas
that merit further research.