Abstract
Objectives: This study aimed to determine the indications, success rate of elective cardioversion and its manifest complications. Methodology: It is a retrospective study involving 53 patients. We reviewed the hospital records files for the demographic data including age, gender, as well as indication of cardioversion, duration of arrhythmia and date of cardioversion along with complications. Results: Out of 53 patients, 58.5% (31) were males with a mean age of 48.17 ± 18.43 years. Arrhythmia related symptoms (palpitations and fatigue) were the indication for cardioversion in 44% (23) of the subjects. Our data showed that 98.1%( 52) were cardioverted to sinus rhythm successfully with a median energy of 100 joules. Out of those who underwent successful cardioversion, 92.5% (49) were followed up till 1 year after the cardioversion. At six week follow up, all the patients were found in sinus rhythm. At 6 months follow up, 94.2% (49) remained in sinus rhythm, while at 1 year follow up, 73% (38) of the patients remained in sinus rhythm. All patients were anticoagulated for at least four weeks after cardioversion. None of the patients required pacemaker and none of them developed stroke after cardioversion. Conclusion: Electrical cardioversion for atrial fibrillation and flutter is a low risk procedure in our population and it has a high success rate and relatively low complications.
Highlights
Atrial flutter (AFL) and atrial fibrillation (AF) are independently associated with thromboembolic complications including stroke.[1]
OR=odds ratio, CI=confidence interval, BMI=body mass index. This is the first study from Pakistan, on patients undergoing direct current cardioversion (DCCV) for atrial fibrillation and flutter
Overall success of the procedure for both AF and AFL to sinus rhythm was 98% (95.5% for atrial fibrillation and 100% for atrial flutter, respectively), which is higher than the wide range reported in literature
Summary
Atrial flutter (AFL) and atrial fibrillation (AF) are independently associated with thromboembolic complications including stroke.[1]. Some of the suggested explanations for the results of the rhythm control strategy were the suboptimal use of anticoagulation, and possible toxicity induced by the used antiarrhythmic agents. Subgroup analysis of the AFFIRM trial suggested that conversion to sinus rhythm (independently of the treatment strategy) and use of oral anticoagulation were independent predictors of survival. Antiarrhythmic agents led to complications and increased mortality.[9]
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