Cardiology clinics
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The prevalence of atrial fibrillation is increasing rapidly, resulting in more patients presenting for care in the emergency department and in-hospital settings. To reduce morbidity and mortality, and improve patient quality of life, clinicians working in these settings need to be both current and facile in their approach to management of these patients. Frequent updates to guideline recommendations (based on emerging research) make this challenging for practicing physicians. This article reviews the acute management of atrial fibrillation in the emergency and in-hospital settings, including practical approaches to rhythm and rate control, anticoagulation, and special situations, incorporating the most up-to-date guidelines.
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Cardiac arrest afflicts more than 300,000 persons annually in North America alone. Improving outcomes after cardiac arrest requires an integrated and multidisciplinary approach to postresuscitation intensive care and subsequent recovery. This article reviews components of injury within the post-cardiac arrest syndrome, the salient features of brain-oriented intensive care, best practices in neurologic prognostication, and a rational approach to emergency revascularization and hemodynamic support.