Key result
Delayed cardioversion linked to ~79% greater acute heart failure risk vs early cardioversion in AF.
Why the study?
Data were limited on clinical outcomes of delayed cardioversion compared with early cardioversion in patients with paroxysmal AF.
Does delayed cardioversion reduce adverse clinical outcomes and resource utilization compared to early cardioversion in patients with paroxysmal atrial fibrillation?
Observational (n=17,879)
Yes
Does delayed cardioversion reduce adverse clinical outcomes and resource utilization compared to early cardioversion in patients with paroxysmal atrial fibrillation?
Odds Ratio: 1.79 (95% CI 1.67–1.92)
p-value: p=<0.01
In patients hospitalized with paroxysmal atrial fibrillation, delayed cardioversion is associated with a significantly higher risk of acute heart failure and increased healthcare resource utilization compared to early cardioversion.
Hypothesis-generating for preferring early cardioversion in paroxysmal AF; prospective randomized trials needed before practice change.
Aim: There is limited data on clinical outcomes of delayed cardioversion (DCV) compared with early cardioversion (ECV) in paroxysmal atrial fibrillation (AF) patients. Methods: We utilized data from National Inpatient Sample (2015–2020) and propensity-score matched analysis to determine adjusted odds ratio (aOR) of major clinical outcomes, including 17,879 AF cases: 9725 and 8154 underwent ECV and DCV, respectively. Results: Compared with ECV, DCV was associated with higher odds of acute heart failure (AHF) (aOR 1.79 [1.67–1.92]; p < 0.01), median length of stay (4 vs 2 days; p < 0.01), and cost of hospitalization ($33,410 vs $21,738; p < 0.01) with no significant difference in inpatient mortality and other cardiovascular and neurological outcomes. Conclusion: Compared with ECV, DCV was associated with more AHF and resource utilization.
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Mohamed et al. (2023) conducted an observational in Paroxysmal atrial fibrillation (n=17,879). Delayed cardioversion vs. Early cardioversion was evaluated on Acute heart failure (AHF) (aOR 1.79, 95% CI 1.67-1.92, p=<0.01). Delayed cardioversion was associated with higher odds of acute heart failure compared with early cardioversion in patients with paroxysmal atrial fibrillation (aOR 1.79; 95% CI 1.67-1.92; p<0.01).
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