Atrial Fibrillation is the most common arrhythmia we see. Conversion to sinus rhythm of recent-onset of atrial fibrillation is proven to be safe. How do you cardiovert? Is a pharmacological cardioversion first approach more successful than an electrical cardioversion first approach in acute atrial fibrillation?
The RAFF-2 Trial(1) Gives Us the answer.
What They Did
The was a two-protocol trial conducted in 11 academic hospitals in Canada. It compared the safety and efficacy of procainamide + electrical cardioversion (DCCV) vs. DCCV alone. It also looked at the cardioversion group and looked to assess the best pad positions.
There were two protocols used:
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