Atrial fibrillation: real-life experience of a rhythm control with electrical cardioversion in a community hospital.
Atrial fibrillation
Community hospital
Electrical cardioversion
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
17 Apr 2024
17 Apr 2024
Historique:
received:
29
12
2023
accepted:
09
04
2024
medline:
19
4
2024
pubmed:
18
4
2024
entrez:
17
4
2024
Statut:
epublish
Résumé
Atrial fibrillation is the most prevalent sustained cardiac arrhythmia. Electrical cardioversion, a well-established part of the rhythm control strategy, is probably underused in community settings. Here, we describe its use, safety, and effectiveness in a cohort of patients with atrial fibrillation treated in rural settings. It is a retrospective cohort study. Data on all procedures from January 1, 2016, till December 1, 2022, in Tarusa Hospital, serving mostly a rural population of 15,000 people, were extracted from electronic health records. Data on the procedure's success, age, gender, body mass index, comorbidities, previous procedures, echocardiographic parameters, type and duration of arrhythmia, anticoagulation, antiarrhythmic drugs, transesophageal echocardiography, and settings were available. Altogether, 1,272 procedures in 435 patients were performed during the study period. The overall effectiveness of the procedure was 92%. Effectiveness was similar across all prespecified subgroups. Electrical cardioversion was less effective in patients undergoing the procedure for the first time (86%, 95% CI: 82-90) compared to repeated procedures (95%, 95% CI: 93-96), OR 0.39 (95% CI: 0.26-0.59). Complications were encountered in 13 (1.02%) procedures but were not serious. Electrical cardioversion is an immediately effective procedure that can be safely performed in community hospitals, both in inpatient and outpatient settings. Further studies with longer follow-up are needed to investigate the rate of sinus rhythm maintenance in these patients.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial fibrillation is the most prevalent sustained cardiac arrhythmia. Electrical cardioversion, a well-established part of the rhythm control strategy, is probably underused in community settings. Here, we describe its use, safety, and effectiveness in a cohort of patients with atrial fibrillation treated in rural settings.
METHODS
METHODS
It is a retrospective cohort study. Data on all procedures from January 1, 2016, till December 1, 2022, in Tarusa Hospital, serving mostly a rural population of 15,000 people, were extracted from electronic health records. Data on the procedure's success, age, gender, body mass index, comorbidities, previous procedures, echocardiographic parameters, type and duration of arrhythmia, anticoagulation, antiarrhythmic drugs, transesophageal echocardiography, and settings were available.
RESULTS
RESULTS
Altogether, 1,272 procedures in 435 patients were performed during the study period. The overall effectiveness of the procedure was 92%. Effectiveness was similar across all prespecified subgroups. Electrical cardioversion was less effective in patients undergoing the procedure for the first time (86%, 95% CI: 82-90) compared to repeated procedures (95%, 95% CI: 93-96), OR 0.39 (95% CI: 0.26-0.59). Complications were encountered in 13 (1.02%) procedures but were not serious.
CONCLUSIONS
CONCLUSIONS
Electrical cardioversion is an immediately effective procedure that can be safely performed in community hospitals, both in inpatient and outpatient settings. Further studies with longer follow-up are needed to investigate the rate of sinus rhythm maintenance in these patients.
Identifiants
pubmed: 38632510
doi: 10.1186/s12872-024-03885-0
pii: 10.1186/s12872-024-03885-0
pmc: PMC11022487
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
213Subventions
Organisme : National project "Science and Universities"
ID : FSER-2022-0013
Organisme : National project "Science and Universities"
ID : FSER-2022-0013
Informations de copyright
© 2024. The Author(s).
Références
Int Arch Med. 2009 Dec 12;2:39
pubmed: 20003371
Int J Cardiol. 2011 Mar 17;147(3):405-8
pubmed: 19861229
Heart. 2004 Dec;90(12):1443-6
pubmed: 15547025
Europace. 2013 Jun;15(6):915-8
pubmed: 23709570
Arch Intern Med. 1996 Dec 9-23;156(22):2585-92
pubmed: 8951302
Br Med J (Clin Res Ed). 1986 Mar 15;292(6522):746-50
pubmed: 3082422
Eur Heart J. 2019 Aug 14;40(31):2555-2556
pubmed: 31411717
Am J Cardiol. 2002 Jan 1;89(1):83-6
pubmed: 11779532
N Engl J Med. 2008 Jun 19;358(25):2667-77
pubmed: 18565859
JAMA. 2020 May 5;323(17):1668-1669
pubmed: 32369128
N Engl J Med. 2018 Feb 01;378(5):417-427
pubmed: 29385358
N Engl J Med. 2002 Dec 5;347(23):1825-33
pubmed: 12466506
BMC Cardiovasc Disord. 2012 Oct 02;12:85
pubmed: 23031215
Heart Lung Circ. 2015 Apr;24(4):342-7
pubmed: 25465515
Circulation. 2009 May 12;119(18):2516-25
pubmed: 19433768
N Engl J Med. 2020 Oct 1;383(14):1305-1316
pubmed: 32865375
Circ Res. 2020 Jun 19;127(1):4-20
pubmed: 32716709
J Clin Nurs. 2019 Oct;28(19-20):3374-3385
pubmed: 30916816
Am Heart J. 2005 Mar;149(3):489-96
pubmed: 15864238
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
N Engl J Med. 2002 Dec 5;347(23):1834-40
pubmed: 12466507
J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14
pubmed: 25559473
J Am Coll Cardiol. 2022 May 17;79(19):1932-1948
pubmed: 35550691