Ambulatory electrical cardioversion of atrial fibrillation

Elective electrical cardioversion of atrial fibrillation is an effective and safe cardiac procedure in selected patients. It is most often performed during a short hospital stay or in an outpatient setting of a hospital. In a retrospective analysis, we report our experience on electrical cardioversions in private practice without a hospital stand-by performed by a cardiologist and an anesthesiologist in concert. Sixty patients with a mean age of 66+/-8 years and a typical spectrum of cardiac diseases in stable condition were chosen for the ambulatory procedure. The immediate success rate of electrical cardioversion was 83%. Within the next 3 months, a relapse of atrial fibrillation occurred in 46%. Following 87 procedures in 60 patients, 3 complications requiring a hospital admission occurred. One of these three patients had suffered from a short syncope without other deficits potentially due to cerebral embolism. Apart from these complications, no patient suffered a thromboembolic complication or a cerebral problem following electrical cardioversion. We conclude that elective electrical cardioversion of atrial fibrillation can be performed safely, effectively and comfortable for patient and physician following a preceding evaluation and counseling by a cardiac specialist.