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The standard wisdom says that patients with atrial fibrillation (AFib) and hemodynamic compromise should undergo immediate cardioversion, but data are lacking to support this practice.
To test the association between cardioversion of AFib and hemodynamic response in critically ill patients, researchers retrospectively examined outcomes in intensive care unit patients who required inotropic drugs or high-dose norepinephrine and underwent electrical cardioversion. The primary outcome measures were norepinephrine and inotrope requirements 6 hours after cardioversion. Hemodynamic nonresponders were defined as those whose norepinephrine requirements did not decrease and who were unable to be weaned from inotropes.
Of 144 patients who underwent car…