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© 1997 Oxford University Press

other

Evaluation of a protocol to select patients of all ages for cardioversion from atrial fibrillation

PETER J. LAWSON-MATTHEW, ADRIAN IONESCU, PATRICK MCHUGH and KEVIN S. CHANNER

Departments of Cardiology and Geriatric Medicine, Royal Hallamshire Hospital Glossop Road, Sheffield SIO 2JF, UK

Address correspondence to: R J. Lawson-Matthew, Department of Health Care for Elderly People, Northern General Hospital, Herries Road, Sheffield S5 7AU. Fax (+44) I 14 271 4996

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.

Keywords: atnal fibnllation, cardioversion, protocol

Received November 5, 1996;
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