Planning and monitoring of patients for electrical cardioversion for atrial fibrillation

J. H. H. Deuling; R. P. Vermeulen; M. D. Smit; J. M. A. A. van der Maaten; H. M. Boersema; A. F. M. van den Heuvel; I. C. Van Gelder

doi:10.1007/s12471-011-0208-z

Planning and monitoring of patients for electrical cardioversion for atrial fibrillation

J. H. H. Deuling, R. P. Vermeulen, M. D. Smit, J. M. A. A. van der Maaten, H. M. Boersema, A. F. M. van den Heuvel, I. C. Van Gelder^*

^*Corresponding author voor dit werk

Cardiovasculair Centrum

Onderzoeksoutput › Academic › peer review

7 Citaten (Scopus)

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This study evaluated the waiting list for elective electrical cardioversion (ECV) for persistent atrial fibrillation (AF), focusing on when and why procedures were postponed. We compared the effects of management of the waiting list conducted by physicians versus management by nurse practitioners (NPs) and we evaluated the safety of our anticoagulating policy by means of bleeding or thromboembolic complications during and after ECV.

Not all patients selected for ECV receive their treatment at the first planned instance due to a variety of reasons. These reasons are still undocumented.

We evaluated 250 consecutive patients with persistent AF admitted to our clinic for elective ECV.

Within 5 to 6 weeks, 186 of 242 patients (77%) received ECV. The main reason for postponing an ECV was an inadequate international normalised ratio (INR); other reasons included spontaneous sinus rhythm and switch to rate control. A total of 23 of the 147 patients (16%) managed by the research physician were postponed due to an inadequate INR at admission versus 4 out of 98 patients (4%) managed by NPs (p = 0.005)

An inadequate INR is the main reason for postponing an ECV. Management of ECV by NPs is safe and leads to less postponing on admission.

Originele taal-2	English
Pagina's (van-tot)	148-154
Aantal pagina's	7
Tijdschrift	Netherlands Heart Journal
Volume	20
Nummer van het tijdschrift	4
DOI's	https://doi.org/10.1007/s12471-011-0208-z
Status	Published - apr.-2012

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title = "Planning and monitoring of patients for electrical cardioversion for atrial fibrillation",

abstract = "This study evaluated the waiting list for elective electrical cardioversion (ECV) for persistent atrial fibrillation (AF), focusing on when and why procedures were postponed. We compared the effects of management of the waiting list conducted by physicians versus management by nurse practitioners (NPs) and we evaluated the safety of our anticoagulating policy by means of bleeding or thromboembolic complications during and after ECV.Not all patients selected for ECV receive their treatment at the first planned instance due to a variety of reasons. These reasons are still undocumented.We evaluated 250 consecutive patients with persistent AF admitted to our clinic for elective ECV.Within 5 to 6 weeks, 186 of 242 patients (77%) received ECV. The main reason for postponing an ECV was an inadequate international normalised ratio (INR); other reasons included spontaneous sinus rhythm and switch to rate control. A total of 23 of the 147 patients (16%) managed by the research physician were postponed due to an inadequate INR at admission versus 4 out of 98 patients (4%) managed by NPs (p = 0.005)An inadequate INR is the main reason for postponing an ECV. Management of ECV by NPs is safe and leads to less postponing on admission.",

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author = "Deuling, {J. H. H.} and Vermeulen, {R. P.} and Smit, {M. D.} and {van der Maaten}, {J. M. A. A.} and Boersema, {H. M.} and {van den Heuvel}, {A. F. M.} and {Van Gelder}, {I. C.}",

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T1 - Planning and monitoring of patients for electrical cardioversion for atrial fibrillation

AU - Deuling, J. H. H.

AU - Vermeulen, R. P.

AU - Smit, M. D.

AU - van der Maaten, J. M. A. A.

AU - Boersema, H. M.

AU - van den Heuvel, A. F. M.

AU - Van Gelder, I. C.

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N2 - This study evaluated the waiting list for elective electrical cardioversion (ECV) for persistent atrial fibrillation (AF), focusing on when and why procedures were postponed. We compared the effects of management of the waiting list conducted by physicians versus management by nurse practitioners (NPs) and we evaluated the safety of our anticoagulating policy by means of bleeding or thromboembolic complications during and after ECV.Not all patients selected for ECV receive their treatment at the first planned instance due to a variety of reasons. These reasons are still undocumented.We evaluated 250 consecutive patients with persistent AF admitted to our clinic for elective ECV.Within 5 to 6 weeks, 186 of 242 patients (77%) received ECV. The main reason for postponing an ECV was an inadequate international normalised ratio (INR); other reasons included spontaneous sinus rhythm and switch to rate control. A total of 23 of the 147 patients (16%) managed by the research physician were postponed due to an inadequate INR at admission versus 4 out of 98 patients (4%) managed by NPs (p = 0.005)An inadequate INR is the main reason for postponing an ECV. Management of ECV by NPs is safe and leads to less postponing on admission.

AB - This study evaluated the waiting list for elective electrical cardioversion (ECV) for persistent atrial fibrillation (AF), focusing on when and why procedures were postponed. We compared the effects of management of the waiting list conducted by physicians versus management by nurse practitioners (NPs) and we evaluated the safety of our anticoagulating policy by means of bleeding or thromboembolic complications during and after ECV.Not all patients selected for ECV receive their treatment at the first planned instance due to a variety of reasons. These reasons are still undocumented.We evaluated 250 consecutive patients with persistent AF admitted to our clinic for elective ECV.Within 5 to 6 weeks, 186 of 242 patients (77%) received ECV. The main reason for postponing an ECV was an inadequate international normalised ratio (INR); other reasons included spontaneous sinus rhythm and switch to rate control. A total of 23 of the 147 patients (16%) managed by the research physician were postponed due to an inadequate INR at admission versus 4 out of 98 patients (4%) managed by NPs (p = 0.005)An inadequate INR is the main reason for postponing an ECV. Management of ECV by NPs is safe and leads to less postponing on admission.

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KW - INR monitoring

KW - Nurse practitioner

KW - INTERNATIONAL NORMALIZED RATIO

KW - CONTROLLED-TRIAL

KW - RHYTHM CONTROL

KW - WARFARIN

KW - THERAPY

KW - SAFETY

KW - ANTICOAGULATION

KW - MAINTENANCE

KW - DABIGATRAN

KW - AMIODARONE

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DO - 10.1007/s12471-011-0208-z

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VL - 20

SP - 148

EP - 154

JO - Netherlands Heart Journal

JF - Netherlands Heart Journal

IS - 4

ER -

Planning and monitoring of patients for electrical cardioversion for atrial fibrillation

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