NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6

Geert Hengstman; Salah A M Saïd; Ramon de Nooijer; Paul J M Voorhorst; Frank H J van der Holst; Francisca F Kamphuis-Wolters; Isabelle C Van Gelder; Harry J G M Crijns

doi:10.1007/s12471-025-01972-1

NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6

Geert Hengstman^*
, Salah A M Saïd
, Ramon de Nooijer
, Paul J M Voorhorst
, Frank H J van der Holst
, Francisca F Kamphuis-Wolters
, Isabelle C Van Gelder
, Harry J G M Crijns

^*Corresponding author for this work

Cardiovascular Centre (CVC)

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Hospital care shifted to home may contribute to sustainability of health care. It is uncertain if home-based electrical cardioversion (ECV) is feasible.

METHODS: RACE‑6 is a prospective proof-of-concept pilot study on feasibility of ECV of persistent symptomatic atrial fibrillation (AF) at patient's homes. It is performed by a mobile nurse-led team, including an emergency care practitioner (ECP) and a sedation nurse, and is remotely supervised by a cardiologist with an ambulance (driver) standby. To ensure safe ECV, the ECP assessed the patients' homes beforehand for accessibility, hygiene, adequate space and light, electrical interference and explosive sources, electricity network stability, and the presence of an adequate informal caregiver overnight.

RESULTS: Six consenting patients with an uneventful previous in-hospital ECV for persistent AF developed one or two symptomatic recurrences and underwent in total 8 separate ECV attempts under conscious sedation at their homes. In all patients sinus rhythm returned and there were no early or late complications. Patients invariably preferred home cardioversion over cardioversion in-hospital.

DISCUSSION: Although applied in highly selected patients, home cardioversion may be extended to a wider selection of patients with persistent AF or even to patients with paroxysmal AF in need of acute restoration of sinus rhythm. Shortening time to cardioversion and early restoration of sinus rhythm may enhance patients' quality of life and postpone AF progression. Home cardioversion may appear safe and improve cost-effectiveness of care but randomized controlled trials are needed to show that home cardioversion may keep AF patients out of the hospital and contribute to the sustainability of health care.

CONCLUSION: Cardioversion at home is feasible and is generally well received by patients.

Original language	English
Pages (from-to)	281-285
Number of pages	5
Journal	Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
Volume	33
Issue number	9
DOIs	https://doi.org/10.1007/s12471-025-01972-1
Publication status	Published - Sept-2025

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Hengstman, G., Saïd, S. A. M., de Nooijer, R., Voorhorst, P. J. M., van der Holst, F. H. J., Kamphuis-Wolters, F. F., Van Gelder, I. C., & Crijns, H. J. G. M. (2025). NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6. Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 33(9), 281-285. https://doi.org/10.1007/s12471-025-01972-1

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title = "NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6",

abstract = "BACKGROUND: Hospital care shifted to home may contribute to sustainability of health care. It is uncertain if home-based electrical cardioversion (ECV) is feasible.METHODS: RACE‑6 is a prospective proof-of-concept pilot study on feasibility of ECV of persistent symptomatic atrial fibrillation (AF) at patient's homes. It is performed by a mobile nurse-led team, including an emergency care practitioner (ECP) and a sedation nurse, and is remotely supervised by a cardiologist with an ambulance (driver) standby. To ensure safe ECV, the ECP assessed the patients' homes beforehand for accessibility, hygiene, adequate space and light, electrical interference and explosive sources, electricity network stability, and the presence of an adequate informal caregiver overnight.RESULTS: Six consenting patients with an uneventful previous in-hospital ECV for persistent AF developed one or two symptomatic recurrences and underwent in total 8 separate ECV attempts under conscious sedation at their homes. In all patients sinus rhythm returned and there were no early or late complications. Patients invariably preferred home cardioversion over cardioversion in-hospital.DISCUSSION: Although applied in highly selected patients, home cardioversion may be extended to a wider selection of patients with persistent AF or even to patients with paroxysmal AF in need of acute restoration of sinus rhythm. Shortening time to cardioversion and early restoration of sinus rhythm may enhance patients' quality of life and postpone AF progression. Home cardioversion may appear safe and improve cost-effectiveness of care but randomized controlled trials are needed to show that home cardioversion may keep AF patients out of the hospital and contribute to the sustainability of health care.CONCLUSION: Cardioversion at home is feasible and is generally well received by patients.",

author = "Geert Hengstman and Sa{\"i}d, \{Salah A M\} and \{de Nooijer\}, Ramon and Voorhorst, \{Paul J M\} and \{van der Holst\}, \{Frank H J\} and Kamphuis-Wolters, \{Francisca F\} and \{Van Gelder\}, \{Isabelle C\} and Crijns, \{Harry J G M\}",

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doi = "10.1007/s12471-025-01972-1",

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Hengstman, G, Saïd, SAM, de Nooijer, R, Voorhorst, PJM, van der Holst, FHJ, Kamphuis-Wolters, FF, Van Gelder, IC & Crijns, HJGM 2025, 'NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6', Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, vol. 33, no. 9, pp. 281-285. https://doi.org/10.1007/s12471-025-01972-1

NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6. / Hengstman, Geert; Saïd, Salah A M; de Nooijer, Ramon et al.
In: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, Vol. 33, No. 9, 09.2025, p. 281-285.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6

AU - Hengstman, Geert

AU - Saïd, Salah A M

AU - de Nooijer, Ramon

AU - Voorhorst, Paul J M

AU - van der Holst, Frank H J

AU - Kamphuis-Wolters, Francisca F

AU - Van Gelder, Isabelle C

AU - Crijns, Harry J G M

PY - 2025/9

Y1 - 2025/9

N2 - BACKGROUND: Hospital care shifted to home may contribute to sustainability of health care. It is uncertain if home-based electrical cardioversion (ECV) is feasible.METHODS: RACE‑6 is a prospective proof-of-concept pilot study on feasibility of ECV of persistent symptomatic atrial fibrillation (AF) at patient's homes. It is performed by a mobile nurse-led team, including an emergency care practitioner (ECP) and a sedation nurse, and is remotely supervised by a cardiologist with an ambulance (driver) standby. To ensure safe ECV, the ECP assessed the patients' homes beforehand for accessibility, hygiene, adequate space and light, electrical interference and explosive sources, electricity network stability, and the presence of an adequate informal caregiver overnight.RESULTS: Six consenting patients with an uneventful previous in-hospital ECV for persistent AF developed one or two symptomatic recurrences and underwent in total 8 separate ECV attempts under conscious sedation at their homes. In all patients sinus rhythm returned and there were no early or late complications. Patients invariably preferred home cardioversion over cardioversion in-hospital.DISCUSSION: Although applied in highly selected patients, home cardioversion may be extended to a wider selection of patients with persistent AF or even to patients with paroxysmal AF in need of acute restoration of sinus rhythm. Shortening time to cardioversion and early restoration of sinus rhythm may enhance patients' quality of life and postpone AF progression. Home cardioversion may appear safe and improve cost-effectiveness of care but randomized controlled trials are needed to show that home cardioversion may keep AF patients out of the hospital and contribute to the sustainability of health care.CONCLUSION: Cardioversion at home is feasible and is generally well received by patients.

AB - BACKGROUND: Hospital care shifted to home may contribute to sustainability of health care. It is uncertain if home-based electrical cardioversion (ECV) is feasible.METHODS: RACE‑6 is a prospective proof-of-concept pilot study on feasibility of ECV of persistent symptomatic atrial fibrillation (AF) at patient's homes. It is performed by a mobile nurse-led team, including an emergency care practitioner (ECP) and a sedation nurse, and is remotely supervised by a cardiologist with an ambulance (driver) standby. To ensure safe ECV, the ECP assessed the patients' homes beforehand for accessibility, hygiene, adequate space and light, electrical interference and explosive sources, electricity network stability, and the presence of an adequate informal caregiver overnight.RESULTS: Six consenting patients with an uneventful previous in-hospital ECV for persistent AF developed one or two symptomatic recurrences and underwent in total 8 separate ECV attempts under conscious sedation at their homes. In all patients sinus rhythm returned and there were no early or late complications. Patients invariably preferred home cardioversion over cardioversion in-hospital.DISCUSSION: Although applied in highly selected patients, home cardioversion may be extended to a wider selection of patients with persistent AF or even to patients with paroxysmal AF in need of acute restoration of sinus rhythm. Shortening time to cardioversion and early restoration of sinus rhythm may enhance patients' quality of life and postpone AF progression. Home cardioversion may appear safe and improve cost-effectiveness of care but randomized controlled trials are needed to show that home cardioversion may keep AF patients out of the hospital and contribute to the sustainability of health care.CONCLUSION: Cardioversion at home is feasible and is generally well received by patients.

U2 - 10.1007/s12471-025-01972-1

DO - 10.1007/s12471-025-01972-1

M3 - Article

C2 - 40745063

SN - 1568-5888

VL - 33

SP - 281

EP - 285

JO - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

JF - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

IS - 9

ER -

NuRse-led home CardiovErsion for control of atrial fibrillation-RACE 6

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