Outcomes Associated With Electrical Cardioversion for Atrial Fibrillation When Performed Autonomously by an Advanced Practice Provider

JACC. Clinical Electrophysiology
Theresa A StrzelczykBradley P Knight

Abstract

This study sought to determine the feasibility, safety, and efficacy of elective electrical cardioversion (CV) for atrial fibrillation (AF) when performed autonomously by a trained advanced practice provider (APP) using a guideline-directed protocol. APPs have emerged as an integral part of the cardiovascular team. A licensed advanced practice nurse-clinical nurse specialist was trained and obtained credentials to perform CVs. The advanced practice nurse performed 415 CVs autonomously (APP group) in a noninvasive procedure room with an electrophysiologist (EP) immediately available in an adjacent electrophysiology laboratory. The APP performed a history and physical examination, obtained informed consent, reviewed each patient with the supervising EP, and performed the CV. An anesthesiologist administered sedation. Outcomes were compared with 387 CVs performed by an MD when the APP was not available (MD group). Patient satisfaction scores were compared before and after the APP-directed CVs were performed. The proportion of patients discharged in sinus rhythm was the same in the APP group as it was in the MD group (95% vs. 96%, respectively; p = 0.49). There were 4 adverse events in the CVs performed by the APP: 1 transient isch...Continue Reading

References

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Jun 12, 2013·Journal of the American College of Cardiology·Clyde W YancyUNKNOWN American Heart Association Task Force on Practice Guidelines
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