Transoesophageal echocardiography and cardioversion: feasibility of a combined approach in clinical practice.
BACKGROUND
Atrial fibrillation, the most common clinically important arrhythmia, is often treated by external cardioversion preceeded by transoesophageal echo (TOE) which are usually performed as separate procedures. We performed TOE and cardioversion as a combined procedure to evaluate its safety and feasibility.


METHODS
173 patients were referred for a combined procedure; 154 underwent a combined TOE and cardioversion. We evaluated the safety and the duration of hospital stay in this group of patients. A cost analysis was performed comparing 32 patients (Group 1) who had a combined procedure in the first 6 months, with 18 patients who had two separate procedures (Group 2) in the 6 months preceeding this.


RESULTS
Analysis of 154 patients who underwent the combined procedure demonstrated a median time from admission to discharge of 9h with a mean procedure time of 36 min. No significant technical problems were identified with the combined procedure as a single sedation. Total admission time, TOE to discharge time (p<0.0001) and procedural costs were lower in Group 1.


CONCLUSIONS
Combined TOE and cardioversion is an effective and safe procedure that permits a patient to have a single sedation with a short hospital stay with decreased health costs.
Thomas
Liza
L
Department of Cardiology, Westmead Hospital, Darcy Road, Sydney, NSW 2145, Australia. lizat@westgate.wh.usyd.edu.au
Veltman
Michael
M
Levett
Kate
K
Hoy
Michelle
M
Ross
David L
DL
D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods; D001281:Atrial Fibrillation / Q000628:therapy*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D017548:Echocardiography, Transesophageal / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D004554:Electric Countershock / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged