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Evaluation of a protocol to select patients of all ages for cardioversion from atrial fibrillation
P J Lawson-Matthew1, A Ionescu, P McHugh
1Department of Cardiology, Royal Hallamshire Hospital, Sheffield, UK.
Objective:
to audit the success of a decision protocol to select patients for cardioversion from atrial fibrillation or flutter by recording the success of cardioversion and the maintenance of sinus rhythm over a 2-year period.
Design:
retrospective case notes review.
Setting:
a teaching hospital coronary care unit and cardiology department.
Patients:
227 consecutive patients were considered for cardioversion from atrial fibrillation or flutter from 1989 to 1992; 128 fulfilled the selection criteria.
Main Outcome Measures:
successful cardioversion and maintenance of sinus rhythm after cardioversion.
Results:
116 (91%) patients selected by application of the guidelines were successfully cardioverted. The probabilities of maintaining sinus rhythm at 6, 12 and 24 months were 0.92, 0.88 and 0.73 respectively.
Conclusion:
careful selection of patients in atrial fibrillation identifies a group in whom cardioversion is likely to be safe and successful regardless of age.