Table 1: Overview of Abstracted Data from Included Studies.
| Study, Country | Centres (n)/Patients (n) | Study Design, Intervention | Setting/Observation Time | Included | SCV rate n (%) |
|---|---|---|---|---|---|
| RCTs | |||||
| Falk et al. 1987,[24] US | 1/36 | RCT, oral digoxin versus placebo | ED/hospitalised, 18 h observation | New-onset AF seen in the ED or on the wards (duration <7 days) | 17/36 (47.2%) |
| Capucci et al. 1992,[17] Italy | 1/62 | RCT, oral flecainide versus IV amiodaron versus placebo | ED/hospitalised, 8 h observation | Recent-onset AF (<7 days) | 10/21 (48%) |
| Capucci et al. 1994,[15] Italy | 1/181 | RCT, oral propafenone versus oral flecainide versus placebo | ED/hospitalised, 8 h observation | Recent-onset AF (<7 days) (if AF >72 h only if chronically anticoagulated) | 24/62 (39%) |
| Bellandi et al. 1996,[20] Italy | 1/182 | RCT, IV propafenone versus placebo | ED/hospitalised, 24 h observation | Paroxysmal AF lasting >30 min but <7 days | 27/84 (32%) |
| Galve et al. 1996,[21] Spain | 1/100 | RCT, IV amiodaron versus placebo | ED/hospitalised, 24 h observation | Recent-onset AF (<7 days) | 30/50 (60%) |
| DAAF trial 1997,[18] Sweden | 13/239 | RCT, IV digoxin versus IV placebo | ED/hospitalised, 16 h observation | Recent-onset AF (<7 days) | 116/239 (48.5%) |
| Azpitarte et al. 1997,[22] Spain | 1/55 | RCT, oral propafenone versus placebo | ED/hospitalised, 24 h observation | All patients with acute AF presenting at the ED | 19/26 (73%) |
| Boriani et al. 1997,[16] Italy | 3/240 | RCT, oral propafenone versus placebo | ED/hospitalised, 8 h observation | Recent-onset AF (<7 days) (if AF >72 h only if chronically anticoagulated) | 45/121(37.2%) |
| Cotter et al. 1999,[7] Israel | 1/100 | RCT, IV amiodaron versus placebo | ED/hospitalised, 24 h observation | Paroxysmal AF <48 h and at least one previous episode of paroxysmal AF | 32/50 (64%) |
| Hohnloser et al. 2004,[14] Germany | 34/201 | RCT, IV tedisamil versus placebo | ED/hospitalised, 2.5 h observation | Symptomatic AF or AFL of 3–48 h duration, BP >90 mmHg systolic and BP <105 mmHg diastolic. | 4/46 (8.7%) |
| Hassan et al. 2007,[23] US | 2/50 | RCT IV diltiazem versus IV esmolol | ED 24h observation (time after drug infusion) | New-onset or paroxysmal AF and a rapid ventricular rate (>100 BPM over 10 min) | 20/50 (40%) |
| Pluymaekers et al. 2019,[8] the Netherlands | 15/437 | RCT, early cardioversion versus wait-and-see | ED 48h observation | Haemodynamic stable, symptomatic patients with AF <36h | 150/218 (69%) |
| Non-RCTs | |||||
| Danias et al. 1998,[3] US | 2/356 | Prospective | ED/hospitalised, observation 4.6 days (time to CV 1.7 days) | AF <72 h | 242/356 (68%) |
| Dell’Orfano et al. 1999,[25] US | 1/114 | Retrospective | ED <48 h observation | Primary diagnosis of AF, documentation of the arrhythmia by single-channel or 12-lead ECG | 57/114 (50%) |
| Mattioli et al. 2000,[28] Italy | 1/140 | Prospective | ED/hospitalised, 48 h observation | Ione AF with a clinically estimated duration of <6 h | 108/140 (77.1%) |
| Mattioli et al. 2005,[27] Italy | 1/116 | Prospective, case control | ED 48 h after onset of symptoms | Haemodynamically stable patients, hospitalised for an acute episode of lone AF (<6 h onset of symptoms) | 72/116 (62.1%) |
| Geleris et al. 2001,[6] Greece | 1/153 | Prospective ED 24 h observation | Consecutive patients with recent onset AF (< 24 h) | 109/153 (71.2%) | |
| Dixon et al. 2005,[26] US | 1/135 | Retrospective | ED/hospitalised, in general monitoring up to 48 h | Primary diagnosis of AF (essential reason for hospital admission) | 71/135 (52.6%) |
| Doyle et al. 2011,[4] Australia | 1/35 | Prospective, wait-and-see | ED 48 h wait-and-see | Patients with stable acute AF <48 h | 22/35 (62.9%) |
| Perrea et al. 2011,[12] Greece | 1/141 | Retrospective pilot study: SCV, amiodaron | ED no observation time | AF at the time of presentation (<48 h) | 28/141 (19.6%) |
| Scheuermeyer et al. 2012,[11] Canada | 2/927 | Retrospective | ED no observation time | Consecutive patients with AF | 121/927 (13.1%) |
| Lindberg et al. 2012,[5] Denmark | 1/374 | Retrospective ED <48 h observation | Consecutive patients admitted to hospital with first onset AF | 203/374 (54%) | |
| Vinson et al. 2012,[13] US | 3/206 | Prospective | ED no observation, small subgroup 48 h wait-and-see | Recent-onset AF (<48 h) | 59/206 (28.6%) 11/16 (68.8%) WAS |
| Choudhary et al. 2013,[19] Sweden | 1/148 | Retrospective | ED SCV <18 h after symptom onset | Patients with paroxysmal AF <48 h | 48/148 (32.4%) |
| Abadie et al. 2019,[29] US | 1/157 | Prospective | ED 30–90 days observation | Low-to-moderate risk AF patient | 48h 98/157 (63%), 30 days 113/136 (83%) |
AFL = atrial flutter; BP = blood pressure; CV = conversion; ED = emergency department; RCT = randomised controlled trial, SCV = spontaneous conversion; WAS = wait-and-see approach.