Simplified cardioversion service with intravenous midazolam.
OBJECTIVE
To assess the results of a new cardioversion service that used intravenous midazolam sedation with cardioversion performed with a biphasic defibrillator by an experienced doctor with a prior review of patients in a pre-cardioversion clinic.


METHODS
368 consecutive patients who were treated under the new service over its first 12 months (group 1) were compared with 210 consecutive patients who attended under the old system during the preceding 12 months (group 2). Patients of group 2 had cardioversion under general anaesthesia by junior doctors with a monophasic defibrillator.


RESULTS
There were no anaesthetic or respiratory complications in group 1. Of the patients in group 1, 10.3% remembered the shocks, with only 3.5% considering them unpleasant. Cardioversion was successful in 94.6% of group 1 patients after a mean energy of 117 J compared with 81.4% (p < 0.0001) and a mean energy of 242 J (p < 0.0001) for group 2 patients. Cancellations on the day of the procedure were reduced from 24% in group 2 to 3.4% in group 1.


CONCLUSIONS
The new service was found to be safe and more efficient. It has led to a large reduction in the waiting time for cardioversion.
Hubner
P J B
PJ
Department of Cardiology, Glenfield Hospital, Leicester, UK.
Gupta
S
S
McClellan
I
I
D000368:Aged; D000768:Anesthesia, General; D047548:Defibrillators; D004554:Electric Countershock / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007275:Injections, Intravenous; D008297:Male; D008485:Medical Audit / Q000379:methods; D008874:Midazolam / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives; D008874:Midazolam