TREATMENT OF ATRIAL FIBRILLATION IN THE EMERGENCY ROOM

Abstract

Introduction: The most common arrhythmia is atrial fibrillation (AF). This condition has increased in prevalence in recent decades. Identification in the emergency is important, as it enables immediate intervention, reducing the chances of cardiovascular complications, including, for example, thrombosis and stroke. The emergency department (ED) approach to AF includes three main aspects: sustainably lowering the heart rate, rhythm control, and preventive measures, when eligible. Objective: To analyze the management of patients with atrial fibrillation in the emergency department. Methodology: This is an integrative review of the last 4 years, from 2021 to 2025, using the Virtual Health Library (VHL) as a research source. The databases used were Medline, IBECS, and LILACS. The descriptors were: "management", "atrial fibrillation", "emergency", and "treatment". A total of 7 articles were found, which were submitted to the selection criteria. The inclusion criteria were articles that were related to the proposal studied and made available in full. The exclusion criteria were articles made available in the form of abstracts. Results and Discussion: Deceleration of the rapid ventricular response is the most common treatment. Drugs such as metoprolol and diltiazem can be used for this purpose. The use of oral drugs associated with intravenous helps in immediate and sustained reduction. Cardioversion is used to control the rhythm, especially electric cardioversion, as it presents greater benefits. Pharmacological treatment can also be used, although with less efficacy, for treatment in refractory cases or by patient choice. Men with CHA₂DS₂-VASc ≥ 2 points and women ≥ 3 points are indicated for anticoagulation to prevent complications, such as in the case of stroke. The identification and respective management of the patient in the ND is important to reduce the patient's morbidity and mortality. Conclusion: From this perspective, the importance of adequate management of AF in the ND is evidenced to improve the patient's prognosis.