Factors related to the success or failure of cardioversion in atrial fibrillation and emergency department revisit according to restoration of sinus rhythm: analysis of the URGFAICS cohort
1Emergency Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
2Emergency Department, Hospital Arnau de Vilanova, 25007 Lleida, Spain
3Emergency Department, Hospital de Viladecans, 08840 Barcelona, Spain
4Emergency Department, Hospital Universitari Joan XXIII de Tarragona, 43001 Tarragona, Spain
5Emergency Department, Hospital Universitari Germans Trias i Pujol de Badalona, 08916 Barcelona, Spain
Submitted: 17 December 2021 Accepted: 12 January 2022
Online publish date: 21 March 2022
Rhythm control in atrial fibrillation (AF) improves haemodynamic status and symptoms. However, there are few data related to revisit of patients who have undergone cardioversion in the Emergency Department (ED). The aim of the study was to compare ED revisit within 30 days according to the effectiveness of cardioversion and analyse the variables related to effective cardioversion. We undertook a multicentre, observational, cohort study with a 30-day follow-up. Older adults with AF presenting to 5 EDs in Spain and undergoing cardioversion were included. The primary endpoint was revisit to the ED within 30 days, and univariate and multivariate analyses were carried out according to the effectiveness of cardioversion. We enrolled 336 patients who underwent cardioversion in the ED. Following the index visit, 7.4% revisited the ED within 30 days, with no differences with respect to the effectiveness of cardioversion (hazard ratio: 0.87; 95%confidence interval (CI) 0.31–2.43). In the multivariate study, AF lasting <48 hours was related to more effective cardioversion (adjusted odds ratio (aOR): 2.14; 95% CI 1.16–3.59) while the use of amiodarone (aOR: 0.52; 95% CI 0.27–0.99) and digoxin in ED (aOR: 0.28; 95% CI 0.13–0.66) was related to less effective cardioversion. In patients with AF undergoing a rhythm control strategy in the ED, the absence of restoration of sinus rhythm was not associated with a greater frequency of 30-day ED revisit.
Atrial fibrillation; Emergency department; Revisit; Sinus rhythm restoration; URGFAICS
Irene Cabello,Javier Jacob,Oriol Yuguero,María Arranz,Jorge-Alexis Guzmán,Anna Moreno,Paloma Francés,Julia Santos,Anna Esquerrà,Álvaro Zarauza,Josep-María Mòdol,on behalf of URGFAICS Research Group. Factors related to the success or failure of cardioversion in atrial fibrillation and emergency department revisit according to restoration of sinus rhythm: analysis of the URGFAICS cohort. Signa Vitae. 2022.doi:10.22514/sv.2022.020.
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