The acute ED management of AF/AFL is variable, and few recommendations exist. The 2006 ACC/AHA/ESC guidelines make no distinction between ventricular rate and rhythm control management. Multiple studies have shown no difference in all-cause mortality, cardiovascular mortality, or stroke rate among patients treated with rate or rhythm control;84-90 however, these studies did not investigate the optimal management choice for new-onset AF/AFL patients presenting to the ED.
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