Pharmacy & Acute Care University
Pharmacy & Acute Care University
Back to Course

PACULit Literature Updates September 2025: Emergency Medicine & Critical Care

0% Complete
0/0 Steps
  1. Use of a drug-related problem oriented medical record in the medication review of critically ill patients Randomized clinical trial
    1 Topic
    |
    1 Quiz
  2. PACULit Daily Literature Update: Stress hyperglycemia ratio as a biomarker for early mortality risk stratification in cardiovascular disease a propensity matched analysis
    1 Topic
    |
    1 Quiz
  3. PACULit Daily Literature Update: Initial serum electrolyte imbalances and mortality in patients with traumatic brain injury a retrospective study
    1 Topic
    |
    1 Quiz
  4. PACULit Daily Literature Update: AsNeeded AlbuterolBudesonide in Mild Asthma
    1 Topic
    |
    1 Quiz
  5. PACULit Daily Literature Update: Thiamine as a metabolic resuscitator after in hospital cardiac arrest
    1 Topic
    |
    1 Quiz
  6. PACULit Daily Literature Update: The Effect of Early Fluid Resuscitation on Mortality in Sepsis A Systematic Review and Meta Analysis
    1 Topic
    |
    1 Quiz
  7. PACULit Daily Literature Update: Inhaled isoflurane for sedation of mechanically ventilated children in intensive care (IsoCOMFORT): a multicentre, randomised, active-control, assessor-masked, non-inferiority phase 3 trial
    1 Topic
    |
    1 Quiz
  8. PACULit Daily Literature Update: Prevalence risk factors and consequences of early clinical deterioration under noninvasive ventilation in emergency department patients a prospective multicentre observational study of the French IRU Network
    1 Topic
    |
    1 Quiz
  9. PACULit Daily Literature Update: Evaluation of Stress Dose Hydrocortisone Tapers in Septic Shock
    1 Topic
    |
    1 Quiz
  10. Opportunistic Screening for Atrial Fibrillation With Continuous ECG Monitoring in the Emergency Department
    1 Topic
    |
    1 Quiz
  11. PACULit Daily Literature Update: Efficacy of targeting high mean arterial pressure for older patients with septic shock OPTPRESS a multicentre pragmatic open label randomised controlled trial
    1 Quiz
  12. PACULit Daily Literature Update: Evaluation of Etomidate Use and Association with Mortality Compared with Ketamine among Critically Ill Patients
    1 Topic
    |
    1 Quiz
  13. PACULit Daily Literature Update: Andexanet alfa increases 30-day thrombotic events relative to four-factor prothrombin complex concentrate for factor Xa inhibitors related intracerebral hemorrhage in veterans
    1 Topic
    |
    1 Quiz
  14. PACULit Daily Literature Update: Antibiotic De-Escalation Practices in the Intensive Care Unit A Multicenter Observational Study
    1 Topic
    |
    1 Quiz
  15. PACULit Daily Literature Update: Fludrocortisone to treat patients with aneurysmal subarachnoid haemorrhage Protocol for an international phase 3 randomised placebocontrolled multicentre trial
    1 Topic
    |
    1 Quiz
  16. PACULit Daily Literature Update: Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest
    1 Topic
    |
    1 Quiz
  17. PACULit Daily Literature Update: Real-Time Hemodynamic Responses to Epinephrine and Their Association with ROSC in Out-of-Hospital Cardiac Arrest
    1 Topic
    |
    1 Quiz
  18. Reevaluating bicarbonate therapy in pediatric DKA A propensity scorematched analysis of neurological and respiratory outcomes
    1 Topic
    |
    1 Quiz
  19. PACULit Daily Literature Update: Establishing discordance rate of estimated glomerular filtration rate between serum creatinine based calculations and cystatin C based calculations in critically ill patients
    1 Topic
    |
    1 Quiz
  20. Alteplase for Posterior Circulation Ischemic Stroke at 45 to 24 Hours
    1 Topic
    |
    1 Quiz
  21. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
    1 Topic
    |
    2 Quizzes
  22. ACPE Required Forms: PACULit Literature Updates September 2025: Emergency Medicine & Critical Care
    3 Topics

Quizzes

Participants 440

  • Allison Clemens
  • April
  • ababaabhay
  • achoi2392
  • adhoward1
Show more
Lesson Progress
0% Complete
PACULit Logo

Daily Literature Update

Opportunistic Screening for Atrial Fibrillation With Continuous ECG Monitoring in the Emergency Department

Bismuth E, Jin BT, Molins E, et al. Opportunistic Screening for Atrial Fibrillation With Continuous ECG Monitoring in the Emergency Department. Ann Emerg Med. 2025 Jul;:-. doi: S0196-0644(25)00386-5. PMID: 40650644.

Introduction

Continuous ECG monitoring in the ED can detect undiagnosed atrial fibrillation, a key risk factor for stroke.

Study Overview

Study Type: Retrospective cohort study

Population: 65,244 adult ED patients with continuous ECG monitoring

Intervention: Opportunistic AF screening via continuous ECG

Outcomes: Undiagnosed AF prevalence, stroke risk, anticoagulation eligibility

Key Findings

  • 3.0% discharged with undiagnosed AF detected by monitoring
  • 71.2% eligible for anticoagulation
  • Undiagnosed AF patients younger, more often female, higher Medicaid/uninsured prevalence
  • Ischemic stroke rate: 2.6 per 100 person-years
  • Adjusted stroke risk HR 3.00 vs no AF, 1.32 vs known AF

Context & Related Research

  • European Society of Cardiology, 2024: Guidelines recommend opportunistic screening with continuous ECG monitoring (PMID: forthcoming), endorsing this study’s approach.
  • Vandermolen et al., 2018: Stroke risk stratification guides anticoagulation in ED AF patients (PMCID: PMC6207234), supporting clinical decision frameworks.
  • Svendsen et al., 2023 (LOOP trial): Increased AF detection and anticoagulation did not significantly reduce stroke (PMID:37458602), highlighting gaps in evidence for outcome benefits.
  • Bismuth et al., 2025: Demonstrates high undiagnosed AF prevalence and stroke risk in underserved ED populations (PMID:40650644), advocating for screening implementation.

Clinical Implications

  • Adopt ED continuous ECG monitoring to identify undiagnosed AF early.
  • Initiate anticoagulation in eligible patients based on stroke risk scores.
  • Address healthcare disparities to ensure equitable AF diagnosis and management.

Strengths & Limitations

Strengths Limitations
Large sample size allowing robust prevalence estimates Retrospective design limits causal conclusions
Comprehensive data on demographic disparities Single-center study may limit generalizability
Stroke incidence outcomes through 2024 Potential confounders and missing data on post-ED anticoagulation

Future Directions

Prospective randomized trials are needed to assess stroke reduction benefits of ED-based continuous ECG AF screening and to evaluate the cost-effectiveness of widespread implementation.

Conclusion

Opportunistic continuous ECG monitoring in the Emergency Department uncovers a significant burden of undiagnosed atrial fibrillation, predominantly among underserved populations, highlighting a critical opportunity for early anticoagulation and stroke prevention.

Listen to the Podcast

A short discussion of today’s highlight.

Open the episode in a new tab

© 2025 PACULit