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Outcomes of patients undergoing elective DC cardioversion for atrial fibrillation: A district general hospital

A Abdullah1, G S Ramewal1, C Wright1

  • 1The Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK.

Journal of Healthcare Quality Research
|September 28, 2025
PubMed

Insights

Early DC cardioversion (DCCV) for atrial fibrillation (AF) is effective. Delays in DCCV at our institution were significant, impacting sinus rhythm maintenance. Amiodarone use post-DCCV improved long-term rhythm control.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Auditing

Background:

  • Early DC cardioversion (DCCV) is effective for restoring sinus rhythm in atrial fibrillation (AF).
  • This audit evaluated DCCV outcomes and predictors of sinus rhythm restoration at our institution.
  • Significant delays in DCCV were observed, particularly when rate control was initiated first.

Purpose of the Study:

  • To assess the outcomes of patients undergoing DCCV.
  • To identify factors predicting successful restoration and maintenance of sinus rhythm post-DCCV.
  • To evaluate the impact of treatment delays on DCCV success rates.

Main Methods:

  • Retrospective audit of elective DCCV procedures performed in 2021.
  • Inclusion of 243 patients with complete electronic case record data.
  • Analysis of patient demographics, treatment delays, procedural success, and rhythm status at follow-up.

Main Results:

  • Immediate DCCV success was 93.1%, with 91.5% maintaining sinus rhythm at discharge.
  • Rhythm maintenance decreased to 48.6% at 6 months and 39.7% at one year.
  • Fewer shocks and continued amiodarone use predicted better long-term sinus rhythm maintenance.

Conclusions:

  • Elective DCCV should be considered early for AF management, avoiding prolonged rate control trials.
  • Significant delays in DCCV at this institution impact long-term rhythm control.
  • Amiodarone use post-DCCV is associated with improved one-year sinus rhythm maintenance.
Abstract

Keywords:
AmiodaronaAmiodaroneAtrial fibrillationCHA2DS2-VASc scoreCardioversión eléctricaDC cardioversionEchocardiogramEcocardiogramaEscala CHA(2)DS(2)-VAScFibrilación auricularRhythm control

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