Management of patients with syncope and cardiac arrhythmias in an emergency department observation unit

Syncope is an ideal condition for the emergency observation setting because of its difficulty in diagnosis, many causes, high liability, and variable diagnostic approaches. Hospital admissions can be averted with appropriate patient selection for a short-term observation period. Atrial fibrillation is a common presenting condition in the emergency department. With aggressive management, the appropriately selected patient can have restoration of sinus rhythm and be safely discharged home.