The outcome of direct current cardioversion (DCC) for the treatment of atrial fibrillation (AF) in a district general hospital in Ireland.
BACKGROUND
Direct current cardioversion (DCC) is a method to control persistent AF, to facilitate a reduction in stroke risk. Although this is a frequently performed procedure, there are no available published data regarding its outcome in an Irish setting.


OBJECTIVE
To determine the short- and long-term outcome of DCC, factors predicting a successful outcome, and its safety.


METHODS
Data relating to each DCC were collected retrospectively from patient notes over a 6.3 year-period, and subsequently entered into a Microsoft Access database before subsequent statistical analysis.


RESULTS
Forty-five consecutive unselected patients were identified, in which 59 DCCs were performed. Sinus rhythm (SR) was achieved immediately after DCC in 54/59 (91%) patients. There was a significant positive correlation between patient body weight and the energy level required to achieve SR (p=0.0001). No thromboembolic complications were noted. After a mean follow-up time of 12 +/- 13.7months, 30/45 (67%) had maintained SR. After univariate analysis, a number of important factors predictive of maintenance of SR at follow-up were identified.


CONCLUSIONS
DCC was found to be an effective method for short- and long-term control of AF, without thromboembolic complications, and patients with a favourable long-term outcome after DCC could conceivably be predicted on the basis of a methodical history, careful examination, simple investigations and pharmacological variables.
O'Rourke
K P
KP
Dept of Medicine, Mallow General Hospital. killianorourke@ireland.com
Cotter
C
C
Mullane
D
D
Thorpe
P
P
Sullivan
P
P
D001281:Atrial Fibrillation / Q000628:therapy*; D004554:Electric Countershock; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome