title: Planning and monitoring of patients for electrical cardioversion for atrial fibrillation.
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  We evaluated 250 consecutive patients with persistent AF admitted to our clinic for elective ECV.
  
  
  RESULTS
  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)
  
  
  CONCLUSIONS
  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.
authors: Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
authors: J H H
authors: JH
authors: Deuling
authors: R P
authors: RP
authors: Vermeulen
authors: M D
authors: MD
authors: Smit
authors: J M A A
authors: JM
authors: van der Maaten
authors: H M
authors: HM
authors: Boersema
authors: A F M
authors: AF
authors: van den Heuvel
authors: I C
authors: IC
authors: Van Gelder