Key result
Community direct current cardioversion restores sinus rhythm in 92% of procedures with minimal complications.
Why the study?
Direct current cardioversion is a well-established rhythm control strategy for atrial fibrillation but is probably underused in community hospital settings.
Is direct current cardioversion effective and safe for patients with atrial fibrillation in a rural community hospital setting?
Cohort (n=430)
No
Is direct current cardioversion effective and safe for patients with atrial fibrillation in a rural community hospital setting?
Direct current cardioversion is highly effective and safe for managing atrial fibrillation in a rural community hospital outpatient setting.
Rural DC cardioversion data support feasibility in community settings; leaves open generalizability and optimal use pending prospective trials.
Background. Atrial fibrillation is the most prevalent sustained cardiac arrhythmia. Direct current 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. 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. Altogether, 1251 procedures in 430 patients were performed during the study period. The overall effectiveness of the procedure was 92\%. Effectiveness was similar across all prespecified subgroups. Direct current cardioversion was slightly less effective in patients undergoing the procedure for the first time (87%, 95% CI: 83--90 vs. 95%, 95% CI: 93--96 for repeated procedures). Complications were encountered in 15 (1.2%) procedures but were not serious. Conclusions. Direct current cardioversion is an immediately effective procedure that can be safely performed in community hospitals in outpatient settings.
No takes yet. Share an insight, caveat, or question.
Okhotin et al. (2024) conducted a cohort in Atrial fibrillation (n=430). Direct current cardioversion was evaluated on Immediate success of the procedure (sinus rhythm restored). Direct current cardioversion performed in a community hospital setting restored sinus rhythm in 92% of procedures, with a low complication rate of 1.2%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: