Safety of emergency-department electric cardioversion for recent-onset atrial fibrillation

Abstract

Objective. To analyze the safety of electric cardioversion performed for recent-onset atrial fibrillation in a hospital emergency department. Methods. Observational retrospective analysis of consecutive emergency department cases of atrial fibrillation of less than 48 hours' duration in hemodynamically stable patients. All included cases were either treated with emergency electric cardioversion or referred for evaluation and scheduling of outpatient cardioversion. The outcome variable was the occurrence of a thromboembolic or hemorrhagic event within 90 days. Results. A total of 718 cardioversions in 570 patients were analyzed. The mean (SD) age of the patients was 64 (13.5) years. Four hundred seventy-nine emergency cardioversions (66.7%) and 239 (33.3%) scheduled cardioversions were performed. Eleven adverse events (1.5% of the cohort) occurred: 2 were thromboembolic events (0.3%) and 9 were hemorrhagic (1.3%). All bleeds were minor. There were no statistically significant differences in the rate of adverse events between the emergency and scheduled cardioversion groups.