Acknowledgements: Dr. Stiell holds a Distinguished Professorship and University Health Research Chair from the University of Ottawa. Dr. Rowe is supported by a Tier I Canada Research Chair in Evidence-based Emergency Medicine through the Government of Canada (Ottawa, ON). Dr. Perry holds a New Investigator Award from the Canadian Institutes of Health Research and a Clinical Research Chair from the University of Ottawa. We would like to thank the research staff at participating hospitals for their contributions towards patient enrolment and follow-up, as well as data collection. The authors acknowledge the following research personnel at the study hospitals: The Ottawa Hospital, Ottawa, Ontario (Pam Sheehan, RN; Pam Ladoucer, RN; Julie Finnigan, RN; Connor Sheehan, BAH; Ellias Horner, BAH; and Linda Brown, RN); Kingston General Hospital, Kingston, Ontario (Kathy Bowes, RN; Karen Lollar, RN; Jane Reid, RN; Nicholas Martin, MD; Gauri Ghate, MD; Carla Graham, RN; and Catherine Bobek, MD); Mount Sinai Hospital, Toronto, Ontario (Michelle Loftus, RN; Genevieve Banshard, RN; and Jackie Ripco, RN); Jewish General Hospital, Montreal, Quebec (Antoinette Colacone, RN; Chris Tselios, BSc; and Paulina Gasioworska, MD); University of Alberta Hospital, Edmonton, Alberta (Debbie Boyko, RN; Jennifer Moore, RN; Mira Singh, MA; Gemma Percival, RN; and Jennifer Goede, RN); Foothills Medical Centre, Calgary, Alberta (Renee Vilneff, RN; Karen Melon, RN; Allan Kostyniuk, BA; Hachem Nasri, MD; Fareen Zaver, MD; Rebecca Machacek, RN candidate; Stevie Anderson, RN candidate; and Carly More, RN candidate); St. Paul’s Hospital, Vancouver, British Columbia (Mahi Etminan, RN; Iraj Poureslami, PhD; Arash Eftekhari, MD; and Maziar Sighary, BSc); Queen Elizabeth II HSC, Halifax, Nova Scotia (Agnieszka Grabowski-Comeau, RN). The authors also acknowledge staff of the hospital health records departments, our colleagues at the Ottawa Hospital Research Institute, and the staff responsible for coordinating these studies (Maureen Lowe, My-Linh Tran, Angela Marcantonio, Sheryl Domingo, Connor Sheehan, BA; and Jennifer Brinkhurst, BA) for their assistance with this project, and Dr. Eddy Lang for his insightful suggestions for the article. Finally, we would like to thank the emergency department physicians and nurses at all participating sites for assisting research teams with identifying potential patients and data collection.
Competing interests: None declared.
1. Stiell, IG, Macle, L. Canadian Cardiovascular Society atrial fibrillation guidelines 2010: management of recent-onset atrial fibrillation and flutter in the emergency department. Can J Cardiol 2011;27(1):38-46.
2. Verma, A, Cairns, JA, Mitchell, L, et al. 2014. Focused update of the Canadian cardiovascular guidelines for the management of atrial fibrillation. Can J Cardiol 2014;30(12):1114-1130.
3. Camm, AJ, Kirchhof, P, Lip, GY, et al. Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010;31(19):2369-2429.
4. Atzema, CL, Austin, PC, Miller, E, et al. A population-based description of atrial fibrillation in the emergency department, 2002 to 2010. Ann Emerg Med 2013;62(6):570-7.e7.
5. Stiell, IG, Clement, CM, Brison, RJ, et al. Variation in management of recent-onset atrial fibrillation and flutter among academic hospital emergency departments. Ann Emerg Med 2011;57(1):13-21.
6. Innes, G, Murphy, M, Nijssen–Jordan, C, et al. Procedural sedation and analgesia in the emergency department. Canadian consensus guidelines. J Emerg Med 1999;17(2):145-156.
7. Campbell, SG, Magee, KD, Kovacs, GJ, et al. Procedural sedation and analgesia in a Canadian adult tertiary care emergency department: a case series. CJEM 2006;8(2):85-93.
8. Kalogridaki, M, Souvatzis, X, Mavrakis, HE, et al. Anaesthesia for cardioversion: a prospective randomized comparison of propofol and etomidate combined with fentanyl. Hell J Cardiol 2011;52:483-488.
9. Wood, J, Ferguson, C. Best evidence topic report. Procedural sedation for cardioversion. Emerg Med J 2006;23(12):932-934.
10. Parlak, M, Parlak, I, Erdur, B, et al. Age effect on efficacy and side effects of two sedation and analgesia protocols on patients going through cardioversion: a randomized clinical trial. Acad Emerg Med 2006;13(5):493-499.
11. Bellone, A, Etteri, M, Vettorello, M, et al. Cardioversion of acute atrial fibrillation in the emergency department: a prospective randomised trial. Emerg Med J 2012;29(3):188-191.
12. Coll-Vinent, B, Sala, X, Fernández, C, et al. Sedation for cardioversion in the emergency department: analysis of effectiveness in four protocols. Ann Emerg Med 2003;42(6):767-772.
13. Stiell, IG, Borgundvaag, B, Clement, CM, et al. Correlates of 30-day adverse events for ED patients with recent-onset atrial fibrillation and flutter (RAFF). CJEM 2013;15(S1):S11.
14. Andolfatto, G, Abu-Laban, RB, Zed, PJ, et al. Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial. Ann Emerg Med 2012;59(6):504-12.e2.
15. Arora, S. Combining ketamine and propofol (“ketofol”) for emergency department procedural sedation and analgesia: a review. West J Emerg Med 2008;9(1):20-23.
16. Messenger, DW, Murray, HE, Dungey, PE, et al. Subdissociative‐dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial. Acad Emerg Med 2008;15(10):877-886.
17. Godwin, SA, Burton, JH, Gerardo, CJ, et al. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med 2014;63(2):247-258.
18. Black, E, Campbell, S, Zed, P. Propofol for procedural sedation in the emergency department: a qualitative systematic review. Ann Pharmacother 2013;47(6):856-868.
19. Bhatt, M, Kennedy, RM, Osmond, MH, et al. Consensus-based recommendations for standardizing terminology and reporting adverse events for emergency department procedural sedation and analgesia in children. Ann Emerg Med 2009;53(4):426-35.e4.