OBJECTIVES: While the short-term (<7-day) safety and efficiency of electrical cardioversion for emergency department (ED) patients with atrial fibrillation or flutter have been established, the 30-day outcomes with respect to stroke, thromboembolic events, or death have not been investigated. METHODS: A two-center cohort of consecutive ED patients undergoing cardioversion for atrial fibrillation or flutter between January 1, 2000, and September 30, 2007, was retrospectively investigated. This cohort was probabilistically linked with both a regional ED database and the provincial health registry to determine which patients had a subsequent ED visit or hospital admission, stroke, or thromboembolic event or died within 30 days. In addition, trained reviewers performed a detailed chart abstraction on 150 randomly selected patients, with emphasis on demographics, vital signs, medical treatment, and predefined adverse events. Hemodynamically unstable patients or those whose condition was the result of an underlying acute medical diagnosis were excluded. Data were analyzed by descriptive methods. RESULTS: During the study period, 1,233 patients made 1,820 visits for atrial fibrillation or flutter to the ED. Of the 400 eligible patients undergoing direct-current cardioversion (DCCV), no patients died, had a stroke, or had a thromboembolic event in the following 30 days (95% confidence interval [CI] = 0.0 to 0.8% for all outcomes). A total of 141 patients were included in the formal chart review, with five patients (3.5%, 95% CI = 0.5% to 6.6%) failing cardioversion, six patients (4.3%, 95% CI = 0.9% to 7.6%) having a minor adverse event that did not change disposition, and five patients (3.5%, 95% CI = 0.5% to 6.6%) admitted to hospital at the index visit. CONCLUSIONS: Cardioversion of patients with atrial fibrillation or flutter in the ED appears to have a very low rate of long-term complications.
OBJECTIVES: While the short-term (<7-day) safety and efficiency of electrical cardioversion for emergency department (ED) patients with atrial fibrillation or flutter have been established, the 30-day outcomes with respect to stroke, thromboembolic events, or death have not been investigated. METHODS: A two-center cohort of consecutive ED patients undergoing cardioversion for atrial fibrillation or flutter between January 1, 2000, and September 30, 2007, was retrospectively investigated. This cohort was probabilistically linked with both a regional ED database and the provincial health registry to determine which patients had a subsequent ED visit or hospital admission, stroke, or thromboembolic event or died within 30 days. In addition, trained reviewers performed a detailed chart abstraction on 150 randomly selected patients, with emphasis on demographics, vital signs, medical treatment, and predefined adverse events. Hemodynamically unstable patients or those whose condition was the result of an underlying acute medical diagnosis were excluded. Data were analyzed by descriptive methods. RESULTS: During the study period, 1,233 patients made 1,820 visits for atrial fibrillation or flutter to the ED. Of the 400 eligible patients undergoing direct-current cardioversion (DCCV), no patients died, had a stroke, or had a thromboembolic event in the following 30 days (95% confidence interval [CI] = 0.0 to 0.8% for all outcomes). A total of 141 patients were included in the formal chart review, with five patients (3.5%, 95% CI = 0.5% to 6.6%) failing cardioversion, six patients (4.3%, 95% CI = 0.9% to 7.6%) having a minor adverse event that did not change disposition, and five patients (3.5%, 95% CI = 0.5% to 6.6%) admitted to hospital at the index visit. CONCLUSIONS: Cardioversion of patients with atrial fibrillation or flutter in the ED appears to have a very low rate of long-term complications.
Authors: Francesco Buccelletti; Salvatore Di Somma; Alberto Galante; Francesco Pugliese; Filippo Alegiani; Giuliano Bertazzoni; Nicolò Gentiloni Silveri; Jacopo M Legramante; Francesco Franceschi Journal: Intern Emerg Med Date: 2011-02-13 Impact factor: 3.397
Authors: Michael Butler; Patrick Froese; Peter Zed; George Kovacs; Robert MacKinley; Kirk Magee; Mary-Lynn Watson; Samuel G Campbell Journal: World J Emerg Med Date: 2017
Authors: Antonio Bonora; Gianni Turcato; Elena Franchi; Gabriele Taioli; Alice Dilda; Germana Zerman; Antonio Maccagnani; Claudio Pistorelli; Oliviero Olivieri Journal: Intern Emerg Med Date: 2016-07-06 Impact factor: 3.397
Authors: Leon M Ptaszek; Christopher W Baugh; Steven A Lubitz; Jeremy N Ruskin; Grace Ha; Margaux Forsch; Samer A DeOliveira; Samia Baig; E Kevin Heist; Jason H Wasfy; David F Brown; Paul D Biddinger; Ali S Raja; Benjamin Scirica; Benjamin A White; Moussa Mansour Journal: J Am Heart Assoc Date: 2019-09-12 Impact factor: 5.501