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Related Experiment Videos

Electrical cardioversion for atrial fibrillation and flutter.

G E Mead1, A T Elder, A D Flapan

  • 1Clinical and Surgical Sciences, University of Edinburgh, Chancellor's Building, New Royal Infirmary, Little France Crescent, Edinburgh, UK, EH16 4SB. gmead@srv1.med.ed.ac.uk

The Cochrane Database of Systematic Reviews
|July 22, 2005
PubMed
Summary
This summary is machine-generated.

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Electrical cardioversion for atrial fibrillation may improve quality of life but shows a trend toward increased stroke risk. Further research is needed to balance these outcomes for patients with atrial fibrillation.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) elevates stroke risk and impairs cardiovascular function.
  • Electrical cardioversion aims to restore normal heart rhythm, potentially mitigating these risks.

Purpose of the Study:

  • To evaluate electrical cardioversion's impact on thromboembolic events, stroke, and mortality in adults with atrial fibrillation or flutter.
  • To assess secondary outcomes including cognitive decline, quality of life, anticoagulant use, and re-hospitalization rates.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled clinical trials.
  • Searched multiple databases (Cochrane CENTRAL, MEDLINE, Embase, CINAHL) and conference proceedings up to May 2004.
  • Included trials comparing electrical cardioversion plus usual care versus usual care alone.

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Main Results:

  • Three completed RCTs involving 927 participants were analyzed.
  • No significant difference in mortality was observed between rhythm control (electrical cardioversion) and rate control strategies.
  • A trend towards increased stroke risk was noted in the rhythm control group (OR 1.9; 95% CI 0.99 to 3.64).
  • Significant improvements in physical functioning, physical role function, and vitality were reported in the rhythm control group.

Conclusions:

  • Electrical cardioversion for atrial fibrillation demonstrated a non-significant increase in stroke risk.
  • Quality of life, specifically in physical functioning and vitality, was improved by electrical cardioversion.