Outcomes after nonemergent electrical cardioversion for atrial arrhythmias

The American Journal of Cardiology
Benjamin Adam SteinbergBimal Ramesh Shah

Abstract

Electrical cardioversion (ECV) is recommended for rhythm control in patients with atrial arrhythmia; yet, ECV use and outcomes in contemporary practice are unknown. We reviewed all nonemergent ECVs for atrial arrhythmias at a tertiary care center (2010 to 2013), stratifying patients by transesophageal echocardiography (TEE) use before ECV and comparing demographics, history, vitals, and laboratory studies. Outcomes included postprocedural success and complications and repeat cardioversion, rehospitalization, and death within 30 days. Overall, 1,017 patients underwent ECV, 760 (75%) for atrial fibrillation and 240 (24%) for atrial flutter; 633 underwent TEE before ECV and 384 did not. TEE recipients were more likely to be inpatients (74% vs 44%, p <0.001), have higher mean CHADS2 scores (2.6 vs 2.4, p = 0.03), and lower mean international normalized ratios (1.2 vs 2.1, p <0.001). Overall, 89 patients (8.8%) did not achieve sinus rhythm and 14 experienced procedural complications (1.4%). Within 30 days, 80 patients (7.9%) underwent repeat ECV, 113 (11%) were rehospitalized, and 14 (1.4%) died. Although ECV success was more common in patients who underwent TEE before ECV (77% vs 68%, p = 0.01), there were no differences in 30-day ...Continue Reading

References

Mar 1, 1986·The American Journal of Cardiology·D L PackerL D German
Jun 13, 2001·JAMA : the Journal of the American Medical Association·B F GageM J Radford
Apr 20, 2005·Medical Care·Elena Birman-DeychBrian F Gage
Sep 16, 2006·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Isabelle C Van GelderUNKNOWN RACE and AFFIRM Investigators
Mar 17, 2010·The New England Journal of Medicine·Isabelle C Van GelderUNKNOWN RACE II Investigators
Mar 19, 2013·Journal of the American College of Cardiology·Jonathan P PicciniUNKNOWN ROCKET AF Steering Committee & Investigators
May 30, 2013·Journal of the Neurological Sciences·Takao HoshinoShinichiro Uchiyama
Feb 22, 2014·International Journal of Cardiology·Harry J G M CrijnsJean-Yves Le Heuzey

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Citations

Oct 1, 2015·European Heart Journal·Dipak Kotecha, Jonathan P Piccini
Feb 25, 2018·Pacing and Clinical Electrophysiology : PACE·Melissa L MorelloRichard J Czosek
Oct 16, 2015·Critical Care Medicine·Charles Weissman

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