Atrial fibrillation: a retrospective chart review of complications, morbidity and mortality at 30 days

Abstract Introduction Atrial fibrillation (AF) increasingly burdens medical health systems. Electrical cardioversion (ECV) forms an important rhythm control treatment for AF. Complications associated with this procedure include stroke and other arrhythmias. Currently, institutional sedation protocols state that patients have to be admitted if 24-hour supervision by family or friends cannot provided. This implies increased costs, both financially occupying a hospital bed. We anticipate strategy of admitting will become problem in the future due rapid increase AF patient aging population. Purpose Our aim is analyse incidence, type timing complications, determine whether additional justified. Methods was retrospective single-centre study, large tertiary care Netherlands. The study approved Ethical Commission, registered Netherlands Trial Register (NL9433). Patients were contacted, those who did not object reuse data included. Data extracted from electronic file, entered into research database, analysed. includes all eligible elective ECV's performed under general anaesthesia, 2019. analysed at number documented complications within 2 hours (T1), between 24 (T2) 30 days ECV (T3). Results In total, 370 approached, 7 refused consent 363 unique 564 procedures majority male (66%), mean age 65±12 years, BMI 28±6 kg/m2, 49% smoker (current past), 19% had previously undergone form ablation, 115 (32%) underwent ≥2 (range 2–11), 6 social indication. T1, 22 16 documented, mostly unrelated anaesthesia: asystole (3, >5 seconds during/after procedure), hypotension (8), extreme bradycardia chest-wall burn pain (1), arrhythmias than developed after (2). Nine ECVs (bradycardia, arrhythmias) considered severe enough admission, 5 diagnosed SSS/brady-tachy syndrome implanted pacemaker later. T2, 11 documented: skin (3), muscle (2), fatigue (4), fainting palpitations (1). latter recurrent AF, readmitted.In T3, 15 which (CVA, angina, heart failure, arrhythmias). Conclusion Based on analysis hospital, 2019, T2 (1,8%) needed no further treatment. therefore conclude it seems safe discharge their homes without extra Funding Acknowledgement Type funding sources: None.