Features of severity assessment of atrial fibrillation paroxysms in emergency medical care

Abstract

Goal. To propose and justify a principle of assessing the severity of atrial fibrillation paroxysms at the prehospital stage. Materials and methods. The study included 398 patients who called an ambulance for paroxysms of atrial fibrillation. According to the results of the analysis of the call cards, the main severity criteria of paroxysm were identified: acute heart failure (HF), high heart rate, myocardial ischemia, hypotension, refractory to pharmacological antiarrhythmic therapy, as well as the impossibility of its use. Results. The contribution of each of the severity criteria to the determination of the degree was studied. The severity of paroxysm does not depend on its duration (p=0.81). The higher the severity of the paroxysm, the more difficult it is to stop (p=0.00) and the higher the need for hospitalization (p=0.01). Conclusion. We introduced the concept of «severity» of paroxysm and demonstrated its dependence on the effectiveness of antiarrhythmic therapy (p=0.00) and the number of hospitalizations (p=0.01). The number of patients whose sinus rhythm is restored at the prehospital stage decreases with increasing severity, and the number of hospitalizations increases.